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Kula H, Ilgen O, Kurt S, Yılmaz F. Patterns of proliferation and fibrosis in a rat model of endometriosis following administration of Allium cepa. Clin Exp Reprod Med 2024; 51:112-119. [PMID: 38263589 PMCID: PMC11140262 DOI: 10.5653/cerm.2023.06261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2023] [Revised: 11/11/2023] [Accepted: 11/14/2023] [Indexed: 01/25/2024] Open
Abstract
OBJECTIVE Endometriosis is a common gynecological disease among reproductive-age women. Numerous hypotheses exist regarding the pathogenesis of endometriosis. In Turkey, the consumption of Allium cepa (commonly known as the "onion cure") is a popular treatment employed to alleviate a variety of gynecological disorders. METHODS In this study, our objective was to assess the therapeutic mechanisms of the onion bulb A. cepa using an autologous endometriosis model in Sprague-Dawley rats. Previous research has shown that A. cepa possesses anti-inflammatory, antioxidant, and antiapoptotic properties. We evaluated the pathological condition of endometriotic implants by employing hematoxylin-eosin staining and Ki67 immunohistochemistry analysis. Transforming growth factor-beta 1 (TGF-β1) and alpha-smooth muscle actin (α-SMA) have been identified as profibrotic markers that are highly overexpressed in endometriotic tissues relative to eutopic endometrial tissue. Furthermore, TGF-β1 influences the differentiation and progression of endometriosis. To quantify profibrotic activity, we measured TGF-β1 and α-SMA using the immunosorbent assay method. RESULTS Lower histologic evaluation scores for endometriotic implants were observed in the group receiving high-dose A. cepa relative to the other groups. Ki67 expression was reduced following the high-dose A. cepa regimen, which consisted of 30% A. cepa and 70% normal feed. However, no statistically significant differences in TGF-β1 or α-SMA levels were observed among the groups (p=0.7 and p=0.778, respectively). CONCLUSION The findings suggest that A. cepa could serve as a therapeutic agent in endometriosis treatment, as evidenced by the reduction in proliferative potential. Nevertheless, A. cepa was not associated with significantly lower levels of endometriosis-associated TGF-β1 or α-SMA.
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Affiliation(s)
- Hakan Kula
- Department of Obstetrics and Gynecology, Dokuz Eylul University, Izmir, Turkey
| | - Orkun Ilgen
- Department of Obstetrics and Gynecology, Dokuz Eylul University, Izmir, Turkey
| | - Sefa Kurt
- Department of Obstetrics and Gynecology, Dokuz Eylul University, Izmir, Turkey
| | - Filiz Yılmaz
- Department of Histology and Embryology, Hitit University, Corum, Turkey
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Akram Z, Mahjabeen I, Irshad F, Ahmed MW, Rehman S, Rizwan M, Shafqat A, Kiran A, Saeed A. Expression deregulation of matrix metalloproteinases and vasoconstriction related genes in Pakistani females with abnormal uterine bleeding. BMC Womens Health 2022; 22:543. [PMID: 36564776 PMCID: PMC9784108 DOI: 10.1186/s12905-022-02132-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2022] [Accepted: 12/14/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Abnormal uterine bleeding (AUB) is irregular menstrual bleeding which has great impact on female health and life style. Various genetic factors are involved in etiology and pathology of AUB. Present study was designed to explore the association of PTGFR, MMP9, MMP2, TGFB3 and VEGFB with AUB. METHODS Blood samples of 212 females with AUB were collected along with age-matched healthy control. Expression variation of targeted genes was evaluated using qPCR. Present study cohort was divided into different groups based on demographic parameters and all targeted genes were correlated with study demographics. RESULTS Expression of targeted genes was significantly (P < 0.001) downregulated in females with AUB compared to control. Reduced (P < 0.01) expression of targeted genes was observed in all age groups (21-30, 31-40, 41-50 year) of AUB patients compared to respective control. Expression of VEGFB increased (P < 0.05) in AUB females with > 9 days bleeding compared to AUB patient had < 9 days bleeding. AUB women with miscarriage history showed upregulation in MMP2, TGFB3 (P < 0.05), and downregulation in MMP9 and VEGFB (P < 0.05) expression compared to AUB group with no miscarriage history. Expression of MMP2 increased (P < 0.05) in AUB females with > 60 kg body weigh compared to AUB patient with < 60 kg weight. CONCLUSION Present study open a new window for diagnosis of AUB at early stages and suggested a possible involvement of PTGFR, MMP9, MMP2, TGFB3 and VEGFB as candidate biomarkers in AUB.
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Affiliation(s)
- Zertashia Akram
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Ishrat Mahjabeen
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Faiza Irshad
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Malik Waqar Ahmed
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Sadaf Rehman
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Muhammad Rizwan
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Amna Shafqat
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Aniqa Kiran
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
| | - Asma Saeed
- grid.418920.60000 0004 0607 0704Cancer Genetics and Epigenetics Lab, Department of Biosciences, COMSATS University Islamabad, Islamabad, Pakistan
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Mwaura AN, Riaz MA, Maoga JB, Mecha E, Omwandho COA, Scheiner-Bobis G, Meinhold-Heerlein I, Konrad L. Activin A Modulates Betaglycan Shedding via the ALK4-SMAD3-Dependent Pathway in Endometriotic Cells. Biomolecules 2022; 12:biom12121749. [PMID: 36551177 PMCID: PMC9776114 DOI: 10.3390/biom12121749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Revised: 11/10/2022] [Accepted: 11/19/2022] [Indexed: 11/27/2022] Open
Abstract
The TGF-β superfamily members, activins and inhibins, are mainly involved in cell proliferation, cell survival, invasion, immune surveillance, and lesion growth in endometriosis. Herein, we investigated the modulation of the TGF-β type III receptor (betaglycan or BG) by activin A and inhibin A in endometriosis in vitro. Often, BG undergoes ectodomain shedding releasing soluble BG (sBG) which frequently antagonizes TGF-β signaling. The effects of activin A on BG shedding and signaling pathways involved were evaluated with the inhibitors LY364947 and SIS3, siRNA knockdown in human endometrial cells (12Z, THESC, Ishikawa, and primary stromal cells) and were quantified with BG ELISAs. The effects of activin A and inhibin A on the secretion of MMP2 and MMP3 were analyzed using ELISAs. The effects of activin A on the BG expression were analyzed using RT-qPCR and western blot. The CCK-8 and BrdU assays were used to evaluate the effects of the recombinant BG on cell viability and proliferation. Activin A stimulation resulted in a significant time- and dose-dependent reduction in BG shedding, which was found to be activin A/ALK-4/SMAD3- but not SMAD2-dependent. Activin A increased the BG mRNA expression but had no effect on the protein expression. Likewise, inhibin A was found to block BG shedding. Activin A, but not inhibin A, significantly enhanced the secretion of MMP2 and MMP3. The recombinant BG had no effect on the viability and proliferation of endometriotic cells. Together, these observations support a novel role for activin A with BG in modulating the TGF-β superfamily ligands in endometrial cells in vitro.
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Affiliation(s)
- Agnes N. Mwaura
- Faculty of Medicine, Center of Gynecology and Obstetrics, Justus-Liebig-University, D-35392 Giessen, Germany
| | - Muhammad A. Riaz
- Faculty of Medicine, Center of Gynecology and Obstetrics, Justus-Liebig-University, D-35392 Giessen, Germany
| | - Jane B. Maoga
- Faculty of Medicine, Center of Gynecology and Obstetrics, Justus-Liebig-University, D-35392 Giessen, Germany
| | - Ezekiel Mecha
- Department of Biochemistry, University of Nairobi, Nairobi P.O. Box 30197-00100, Kenya
| | - Charles O. A. Omwandho
- Department of Biochemistry, University of Nairobi, Nairobi P.O. Box 30197-00100, Kenya
- Department of Health Sciences, Kirinyaga University, Kerugoya P.O. Box 143-10300, Kenya
| | - Georgios Scheiner-Bobis
- Institute for Veterinary Physiology and Biochemistry, School of Veterinary Medicine, Justus-Liebig-University, D-35392 Giessen, Germany
| | - Ivo Meinhold-Heerlein
- Faculty of Medicine, Center of Gynecology and Obstetrics, Justus-Liebig-University, D-35392 Giessen, Germany
| | - Lutz Konrad
- Faculty of Medicine, Center of Gynecology and Obstetrics, Justus-Liebig-University, D-35392 Giessen, Germany
- Correspondence: ; Tel.: +49-641-985-45282; Fax: +49-641-985-45258
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Mwaura AN, Riaz MA, Maoga JB, Mecha E, Omwandho COA, Scheiner-Bobis G, Meinhold-Heerlein I, Konrad L. Role of Betaglycan in TGF-β Signaling and Wound Healing in Human Endometriotic Epithelial Cells and in Endometriosis. BIOLOGY 2022; 11:biology11040513. [PMID: 35453712 PMCID: PMC9027931 DOI: 10.3390/biology11040513] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/18/2022] [Revised: 03/15/2022] [Accepted: 03/22/2022] [Indexed: 12/16/2022]
Abstract
Endometriosis is characterized by the presence of ectopic endometrium most often in the pelvis. The transforming growth factor-beta (TGF-β) superfamily is also involved in the pathogenesis; however, betaglycan (BG, syn. TGF-β type III receptor) as an important co-receptor was not studied. We analyzed mainly BG ectodomain shedding because released soluble BG (sBG) often antagonizes TGF-β signaling. Furthermore, we studied the role of TGF-βs and BG in wound healing and evaluated the suitability of BG measurements in serum and endocervical mucus for non-invasive diagnosis of endometriosis. Evaluation of the BG shedding and signaling pathways involved as well as wound healing was performed with enzyme-linked immune assays (ELISAs), reverse transcription-quantitative polymerase chain reaction (RT-qPCR), small interfering RNA (siRNA) knockdown, and scratch assays with human endometriotic epithelial cells. TGF-β1/2 stimulation resulted in a significant dose-dependent reduction in BG shedding in endometriotic cells, which was TGF-β/activin receptor-like kinase-5 (ALK-5)/mother against decapentaplegic homolog3 (SMAD3)- but not SMAD2-dependent. Inhibition of matrix metalloproteinases (MMPs) using the pan-MMP inhibitor GM6001 and tissue inhibitor of MMPs (TIMP3) equally attenuated BG shedding, signifying the involvement of MMPs in shedding. Likewise, recombinant BG moderately reduced the secretion of TGF-β1/2 and wound healing of endometriotic cells. TGF-β1 significantly enhanced the secretion of MMP2 and MMP3 and moderately promoted wound healing. In order to evaluate the role of BG in endometriosis, serum (n = 238) and mucus samples (n = 182) were analyzed. Intriguingly, a significant reduction in the levels of sBG in endocervical mucus but not in the serum of endometriosis patients compared to controls was observed. Collectively, these observations support a novel role for BG in the pathophysiology of endometriosis.
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Affiliation(s)
- Agnes N. Mwaura
- Center of Gynecology and Obstetrics, Faculty of Medicine, Justus-Liebig-University, Feulgenstr. 10-12, D-35392 Giessen, Germany; (A.N.M.); (M.A.R.); (J.B.M.); (I.M.-H.)
| | - Muhammad A. Riaz
- Center of Gynecology and Obstetrics, Faculty of Medicine, Justus-Liebig-University, Feulgenstr. 10-12, D-35392 Giessen, Germany; (A.N.M.); (M.A.R.); (J.B.M.); (I.M.-H.)
| | - Jane B. Maoga
- Center of Gynecology and Obstetrics, Faculty of Medicine, Justus-Liebig-University, Feulgenstr. 10-12, D-35392 Giessen, Germany; (A.N.M.); (M.A.R.); (J.B.M.); (I.M.-H.)
| | - Ezekiel Mecha
- Department of Biochemistry, University of Nairobi, Nairobi 00100, Kenya;
| | | | - Georgios Scheiner-Bobis
- Institute for Veterinary Physiology and Biochemistry, School of Veterinary Medicine, Justus-Liebig-University, D-35392 Giessen, Germany;
| | - Ivo Meinhold-Heerlein
- Center of Gynecology and Obstetrics, Faculty of Medicine, Justus-Liebig-University, Feulgenstr. 10-12, D-35392 Giessen, Germany; (A.N.M.); (M.A.R.); (J.B.M.); (I.M.-H.)
| | - Lutz Konrad
- Center of Gynecology and Obstetrics, Faculty of Medicine, Justus-Liebig-University, Feulgenstr. 10-12, D-35392 Giessen, Germany; (A.N.M.); (M.A.R.); (J.B.M.); (I.M.-H.)
- Correspondence: ; Tel./Fax: +49-641-985-45282
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5
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Zakrzewski PK. Canonical TGFβ Signaling and Its Contribution to Endometrial Cancer Development and Progression-Underestimated Target of Anticancer Strategies. J Clin Med 2021; 10:3900. [PMID: 34501347 PMCID: PMC8432036 DOI: 10.3390/jcm10173900] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Revised: 08/24/2021] [Accepted: 08/26/2021] [Indexed: 02/08/2023] Open
Abstract
Endometrial cancer is one of the leading gynecological cancers diagnosed among women in their menopausal and postmenopausal age. Despite the progress in molecular biology and medicine, no efficient and powerful diagnostic and prognostic marker is dedicated to endometrial carcinogenesis. The canonical TGFβ pathway is a pleiotropic signaling cascade orchestrating a variety of cellular and molecular processes, whose alterations are responsible for carcinogenesis that originates from different tissue types. This review covers the current knowledge concerning the canonical TGFβ pathway (Smad-dependent) induced by prototypical TGFβ isoforms and the involvement of pathway alterations in the development and progression of endometrial neoplastic lesions. Since Smad-dependent signalization governs opposed cellular processes, such as growth arrest, apoptosis, tumor cells growth and differentiation, as well as angiogenesis and metastasis, TGFβ cascade may act both as a tumor suppressor or tumor promoter. However, the final effect of TGFβ signaling on endometrial cancer cells depends on the cancer disease stage. The multifunctional role of the TGFβ pathway indicates the possible utilization of alterations in the TGFβ cascade as a potential target of novel anticancer strategies.
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Affiliation(s)
- Piotr K Zakrzewski
- Department of Cytobiochemistry, Faculty of Biology and Environmental Protection, University of Lodz, Pomorska 141/143, 90-236 Lodz, Poland
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De Conto E, Matte U, Cunha-Filho JS. BMP-6 and SMAD4 gene expression is altered in cumulus cells from women with endometriosis-associated infertility. Acta Obstet Gynecol Scand 2020; 100:868-875. [PMID: 32524577 DOI: 10.1111/aogs.13931] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2020] [Revised: 05/27/2020] [Accepted: 06/01/2020] [Indexed: 02/06/2023]
Abstract
INTRODUCTION Oocyte competence and quality depend on communication between the oocyte and the cumulus and theca cells. In the preantral phase, the members of the transforming growth factor β (TGF-β) superfamily are responsible for this communication and play an important role in folliculogenesis. Members of the TGF-β superfamily are related to endometriosis (overexpression in the ectopic endometrium); however, few studies have explored these proteins as influencing fertility in endometriosis. Considering endometriosis-related infertility and to better understand the role of the TGF-β superfamily members in the antral phase in women with endometriosis, this research investigated the gene expression of the genes for ligands AMH, BMP-6, GDF-9, INHA, INHBB, and TGFβ3; receptors AMHR2, BMPR2, and TGFβR3; and intracellular signalling: SMAD3 and SMAD4. MATERIAL AND METHODS The gene expression of AMH, BMP-6, GDF-9, INHA, INHBB, TGFβ3, AMHR2, BMPR2, TGFβR3, SMAD3, and SMAD4 in cumulus cells was investigated through quantitative real-time PCR in a case-control study including infertile women with and without peritoneal endometriosis undergoing in vitro fertilization. RESULTS Age and outcomes of assisted reproduction were similar between the groups (P > .05). However, women with endometriosis showed reduced expression of BMP-6 and SMAD4 (P < .05) in cumulus cells compared with the control group, other genes did not present altered gene expression in women with endometriosis (P > .05). CONCLUSIONS The reduced expression of BMP-6 and SMAD4 in women with peritoneal endometriosis compared with the control group indicates that granulosa (cumulus) cell function could be altered in these women.
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Affiliation(s)
- Emily De Conto
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Ursula Matte
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - João Sabino Cunha-Filho
- Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.,Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
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7
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Transforming growth factor β (TGF-β): is there a different role with regard to distinct phenotypes of endometriosis? Immunol Lett 2019; 211:1-2. [DOI: 10.1016/j.imlet.2019.05.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2019] [Accepted: 05/07/2019] [Indexed: 11/19/2022]
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8
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Xie Q, He H, Wu YH, Zou LJ, She XL, Xia XM, Wu XQ. Eutopic endometrium from patients with endometriosis modulates the expression of CD36 and SIRP-α in peritoneal macrophages. J Obstet Gynaecol Res 2019; 45:1045-1057. [PMID: 30843336 PMCID: PMC6593754 DOI: 10.1111/jog.13938] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 01/18/2019] [Indexed: 12/19/2022]
Abstract
Aim This study aimed to investigate the in vitro alterations of the expression of signal regulatory protein‐α (SIRP‐α) and CD36 in macrophages in the endometriosis condition. Methods The expression of SIRP‐α and CD36 was measured in peritoneal macrophages and peripheral blood mononuclear cells of endometriosis patients and control participants. The expressions of SIRP‐α and CD36 were measured in human acute monocytic leukemia (THP‐1) cell‐derived macrophages that were treated with interleukin‐6 (IL‐6)‐induced conditioned medium, eutopic versus normal endometrial homogenate, or lipopolysaccharide in the presence or absence of nuclear factor kappa‐B (NF‐κB) or transforming growth factor (TGF‐β) inhibitors, respectively. Results Peritoneal macrophages that were isolated from women with endometriosis exhibited an enhanced expression of SIRP‐α and a decreased expression of CD36 compared to control participants. Women with endometriosis had significantly higher levels of SIRP‐α and CD36 in peripheral circulating mononuclear cells than in control participants. SIRP‐α expression was significantly increased, whereas the CD36 expression was decreased in THP‐1 cell‐derived macrophages after treatment with eutopic endometrial homogenate. Intervention with IL‐6‐induced conditioned medium resulted in the downregulation of SIRP‐α but the upregulation of CD36 in THP‐1 cells. Incubation with the NF‐κBp50 inhibitor decreased the expression of CD36 and SIRP‐α in macrophages that were treated with normal endometrial homogenate, whereas the TGF‐β inhibitor enhanced the CD36 expression of THP‐1 cell‐derived macrophages treated with eutopic endometrial homogenate. Conclusion The eutopic endometrium could reduce the phagocytic ability of peritoneal macrophages in women with endometriosis through the modulation of SIRP‐α and CD36 expression. Inhibition of the TGF‐β signal pathway may be a potential therapeutic target for the treatment of endometriosis.
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Affiliation(s)
- Qi Xie
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Hua He
- Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Ya-Hong Wu
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Lu-Jie Zou
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiao-Ling She
- Department of Pathology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xiao-Meng Xia
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, China
| | - Xian-Qing Wu
- Department of Obstetrics and Gynecology, The Second Xiangya Hospital of Central South University, Changsha, China
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Panir K, Schjenken JE, Robertson SA, Hull ML. Non-coding RNAs in endometriosis: a narrative review. Hum Reprod Update 2019; 24:497-515. [PMID: 29697794 DOI: 10.1093/humupd/dmy014] [Citation(s) in RCA: 101] [Impact Index Per Article: 20.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2017] [Accepted: 04/05/2018] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Endometriosis is a benign gynaecological disorder, which affects 10% of reproductive-aged women and is characterized by endometrial cells from the lining of the uterus being found outside the uterine cavity. However, the pathophysiological mechanisms causing the development of this heterogeneous disease remain enigmatic, and a lack of effective biomarkers necessitates surgical intervention for diagnosis. There is international recognition that accurate non-invasive diagnostic tests and more effective therapies are urgently needed. Non-coding RNA (ncRNA) molecules, which are important regulators of cellular function, have been implicated in many chronic conditions. In endometriosis, transcriptome profiling of tissue samples and functional in vivo and in vitro studies demonstrate that ncRNAs are key contributors to the disease process. OBJECTIVE AND RATIONALE In this review, we outline the biogenesis of various ncRNAs relevant to endometriosis and then summarize the evidence indicating their roles in regulatory pathways that govern disease establishment and progression. SEARCH METHODS Articles from 2000 to 2016 were selected for relevance, validity and quality, from results obtained in PubMed, MEDLINE and Google Scholar using the following search terms: ncRNA and reproduction; ncRNA and endometriosis; miRNA and endometriosis; lncRNA and endometriosis; siRNA and endometriosis; endometriosis; endometrial; cervical; ovary; uterus; reproductive tract. All articles were independently screened for eligibility by the authors. OUTCOMES This review integrates extensive information from all relevant published studies focusing on microRNAs, long ncRNAs and short inhibitory RNAs in endometriosis. We outline the biological function and synthesis of microRNAs, long ncRNAs and short inhibitory RNAs and provide detailed findings from human research as well as functional studies carried out both in vitro and in vivo, including animal models. Although variability in findings between individual studies exists, collectively, the extant literature justifies the conclusion that dysregulated ncRNAs are a significant element of the endometriosis condition. WIDER IMPLICATIONS There is a compelling case that microRNAs, long non-coding RNAs and short inhibitory RNAs have the potential to influence endometriosis development and persistence through modulating inflammation, proliferation, angiogenesis and tissue remodelling. Rapid advances in ncRNA biomarker discovery and therapeutics relevant to endometriosis are emerging. Unravelling the significance of ncRNAs in endometriosis will pave the way for new diagnostic tests and identify new therapeutic targets and treatment approaches that have the potential to improve clinical options for women with this disabling condition.
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Affiliation(s)
- Kavita Panir
- The Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - John E Schjenken
- The Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - Sarah A Robertson
- The Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia
| | - M Louise Hull
- The Robinson Research Institute and Adelaide Medical School, The University of Adelaide, Adelaide, South Australia, Australia.,Fertility SA, Adelaide, South Australia, Australia.,Department of Obstetrics and Gynaecology, Women's and Children's Hospital Adelaide, South Australia, Australia
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Koninckx PR, Ussia A, Adamyan L, Wattiez A, Gomel V, Martin DC. Pathogenesis of endometriosis: the genetic/epigenetic theory. Fertil Steril 2018; 111:327-340. [PMID: 30527836 DOI: 10.1016/j.fertnstert.2018.10.013] [Citation(s) in RCA: 200] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 10/16/2018] [Accepted: 10/17/2018] [Indexed: 12/17/2022]
Abstract
OBJECTIVE To study the pathophysiology of endometriosis. DESIGN Overview of observations on endometriosis. SETTING Not applicable. PATIENT(S) None. INTERVENTIONS(S) None. MAIN OUTCOME MEASURE(S) The hypothesis is compatible with all observations. RESULT(S) Endometriosis, endometrium-like tissue outside the uterus, has a variable macroscopic appearance and a poorly understood natural history. It is a hereditary and heterogeneous disease with many biochemical changes in the lesions, which are clonal in origin. It is associated with pain, infertility, adenomyosis, and changes in the junctional zone, placentation, immunology, plasma, peritoneal fluid, and chronic inflammation of the peritoneal cavity. The Sampson hypothesis of implanted endometrial cells following retrograde menstruation, angiogenic spread, lymphogenic spread, or the metaplasia theory cannot explain all observations if metaplasia is defined as cells with reversible changes and an abnormal behavior/morphology due to the abnormal environment. We propose a polygenetic/polyepigenetic mechanism. The set of genetic and epigenetic incidents transmitted at birth could explain the hereditary aspects, the predisposition, and the endometriosis-associated changes in the endometrium, immunology, and placentation. To develop typical, cystic ovarian or deep endometriosis lesions, a variable series of additional transmissible genetic and epigenetic incidents are required to occur in a cell which may vary from endometrial to stem cells. Subtle lesions are viewed as endometrium in a different environment until additional incidents occur. Typical cystic ovarian or deep endometriosis lesions are heterogeneous and represent three different diseases. CONCLUSION(S) The genetic epigenetic theory is compatible with all observations on endometriosis. Implications for treatment and prevention are discussed.
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Affiliation(s)
- Philippe R Koninckx
- Obstetrics-Gynecology, KU Leuven, Bierbeek, Belgium; Gruppo Italo Belga, Rome, Italy; Latiffa Hospital, Dubai, United Arab Emirates; Università Cattolica, Roma, Italy.
| | - Anastasia Ussia
- Gruppo Italo Belga, Rome, Italy; Università Cattolica, Roma, Italy
| | - Leila Adamyan
- Department of Operative Gynecology, Federal State Budget Institution V. I. Kulakov Research Centre for Obstetrics, Gynecology, and Perinatology, Ministry of Health of the Russian Federation, and Department of Reproductive Medicine and Surgery, Moscow State University of Medicine and Dentistry, Moscow, Russia
| | - Arnaud Wattiez
- Latiffa Hospital, Dubai, United Arab Emirates; Department of Obstetrics and Gynecology, University of Strasbourg, Strasbourg, France
| | - Victor Gomel
- Department of Obstetrics and Gynecology, University of British Columbia and Women's Hospital, Vancouver, British Columbia, Canada
| | - Dan C Martin
- School of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee, and Virginia Commonwealth University, Richmond, Virginia
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11
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Soni UK, Chadchan SB, Kumar V, Ubba V, Khan MTA, Vinod BSV, Konwar R, Bora HK, Rath SK, Sharma S, Jha RK. A high level of TGF-B1 promotes endometriosis development via cell migration, adhesiveness, colonization, and invasiveness†. Biol Reprod 2018; 100:917-938. [DOI: 10.1093/biolre/ioy242] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 12/29/2017] [Accepted: 11/12/2018] [Indexed: 12/24/2022] Open
Affiliation(s)
- Upendra Kumar Soni
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | | | - Vijay Kumar
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Vaibhave Ubba
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | | | | | - Rituraj Konwar
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Himangsu Kousik Bora
- Animal Laboratory Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Srikanta Kumar Rath
- Toxicology and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Sharad Sharma
- Toxicology and Experimental Medicine Division, CSIR-Central Drug Research Institute, Lucknow, India
| | - Rajesh Kumar Jha
- Endocrinology Division, CSIR-Central Drug Research Institute, Lucknow, India
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12
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The involvement of multifunctional TGF-β and related cytokines in pathogenesis of endometriosis. Immunol Lett 2018; 201:31-37. [PMID: 30367890 DOI: 10.1016/j.imlet.2018.10.011] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2018] [Revised: 09/21/2018] [Accepted: 10/22/2018] [Indexed: 12/12/2022]
Abstract
PURPOSE Transforming growth factor β (TGF-β) is one of the major immune and inflammation factors responsible for regulating cell proliferation, differentiation, angiogenesis, and immune responses. Deregulated TGF-β activity, especially its influence in peritoneal cytokine cross-talk, has been implicated in pathologies of endometriosis. The aim of this study was to determine whether TGF-β could be involved in the pathogenesis of endometriosis. For this purpose, we evaluated concentrations of TGFβ1, TGF-β2, TGF-β3 and interleukin (IL)-1β, IL-6, IL-10, IL-17, IL-21 and IL-22 in peritoneal fluid (PF) and serum of women with endometriosis. METHODS A total of 66 women of reproductive age were involved in the study, 51 endometriosis patients, and 15 women from the control group. PF and serum levels of all cytokines were measured with ELISA in women with or without endometriosis. RESULTS Higher PF and serum levels of TGF-β1, TGF-β2, TGF-β3, presented also as a total TGF-β in women with endometriosis compared to control were observed. The biggest increase was measured in the case of TGF-β1. The higher levels of IL-1β, IL-6, IL-10, and IL-17 in PF and serum of endometriosis women than control was observed. Higher PF levels of studied parameters in comparison with serum levels were found. CONCLUSIONS In endometriosis, TGF-β could affect differentiation of T helper (Th) cells, hence produce more IL-17 and IL-10 to PF and might have an indirect influence on inflammation, which is associated with higher IL-1β and IL-6 levels. In consequent, TGF-β in peritoneal fluid may promote an environment favorable to ectopic lesion formation.
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Li Z, Liu H, Lang J, Zhang G, He Z. Effects of cisplatin on surgically induced endometriosis in a rat model. Oncol Lett 2018; 16:5282-5290. [PMID: 30250597 PMCID: PMC6144798 DOI: 10.3892/ol.2018.9275] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 05/22/2018] [Indexed: 12/19/2022] Open
Abstract
Research has strongly suggested that the features of endometriosis serve as a precursor lesion of ovarian cancer. Cisplatin (CDDP) is the preferred drug against these cancer types. The present study investigated the effects of CDDP on surgically induced endometriosis in a rat model. Endometriosis was surgically induced by the autologous transplantation of endometrial tissue. A total of 36 model rats were randomly divided into three groups. The rats in Group 1 (control group, n=12) received no medication. The rats in Group 2 (n=12) and Group 3 (n=12) were administered 35 mg/m2 CDDP and 70 mg/m2 CDDP, respectively, every four days. All rats were treated for a total of 24 days. The growth and histologic scores of the implants were calculated. The expression of protein markers, including vascular endothelial growth factor (VEGF), aromatase P450 (P450arom), transforming growth factor-β (TGF-β) and matrix metalloproteinase (MMP)-2, were assessed using immunohistochemistry, an enzyme-linked immunosorbent assay and western blot analysis. Following CDDP treatment, the mean implant sizes were significantly reduced in Groups 2 and 3 compared with the control group (P=0.01). The mean histologic scores were also significantly lower in Groups 2 and 3. Furthermore, the protein expression of VEGF, P450arom, TGF-β and MMP-2 was significantly lower in Groups 2 and 3 when compared with the control group. A loss of hair was observed in 4 rats, which only occurred in Group 3. A dose-dependent effect was observed in the two CDDP-treated groups. In conclusion, the expression of proliferation- and angiogenesis-associated proteins was significantly lower following treatment with CDDP. CDDP caused a significant regression in the size of the endometriotic implants and induced atrophy of these lesions in rats.
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Affiliation(s)
- Zhanfei Li
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China.,Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100005, P.R. China
| | - Huibing Liu
- Department of Obstetrics and Gynecology, Nanfang Hospital, Southern Medical University, Guangzhou, Guangdong 510515, P.R. China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100005, P.R. China
| | - Guorui Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100005, P.R. China
| | - Zhengxing He
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Beijing 100005, P.R. China
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14
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Choi HJ, Park MJ, Kim BS, Choi HJ, Joo B, Lee KS, Choi JH, Chung TW, Ha KT. Transforming growth factor β1 enhances adhesion of endometrial cells to mesothelium by regulating integrin expression. BMB Rep 2018; 50:429-434. [PMID: 28760197 PMCID: PMC5595173 DOI: 10.5483/bmbrep.2017.50.8.097] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2017] [Indexed: 12/11/2022] Open
Abstract
Endometriosis is the abnormal growth of endometrial cells outside the uterus, causing pelvic pain and infertility. Furthermore, adhesion of endometrial tissue fragments to pelvic mesothelium is required for the initial step of endometriosis formation outside uterus. TGF-β1 and adhesion molecules importantly function for adhesion of endometrial tissue fragments to mesothelium outside uterus. However, the function of TGF-β1 on the regulation of adhesion molecule expression for adhesion of endometrial tissue fragments to mesothelium has not been fully elucidated. Interestingly, transforming growth factor β1 (TGF-β1) expression was higher in endome-triotic epithelial cells than in normal endometrial cells. The adhesion efficiency of endometriotic epithelial cells to meso-thelial cells was also higher than that of normal endometrial cells. Moreover, TGF-β1 directly induced the adhesion of endometrial cells to mesothelial cells through the regulation of integrin of αV, α6, β1, and β4 via the activation of the TGF-β1/TGF-βRI/Smad2 signaling pathway. Conversely, the adhesion of TGF-β1-stimulated endometrial cells to mesothelial cells was clearly reduced following treatment with neutralizing antibodies against specific TGF-β1-mediated integrins αV, β1, and β4 on the endometrial cell membrane. Taken together, these results suggest that TGF-β1 may act to promote the initiation of endometriosis by enhancing integrin-mediated cell-cell adhesion.
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Affiliation(s)
- Hee-Jung Choi
- Department of Korean Medical Science, School of Korean Medicine and Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan 50612, Korea
| | - Mi-Ju Park
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan 50612, Korea
| | - Bo-Sung Kim
- Department of Korean Medical Science, School of Korean Medicine, Healthy Aging Korean Medical Research Center and Graduate Training Program of Korean Medicine for Healthy-aging, Pusan National University, Yangsan 50612, Korea
| | - Hee-Jin Choi
- Department of Korean Medical Science, School of Korean Medicine, Healthy Aging Korean Medical Research Center and Graduate Training Program of Korean Medicine for Healthy-aging, Pusan National University, Yangsan 50612, Korea
| | - Bosun Joo
- Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan 50612, Korea
| | - Kyu Sup Lee
- Department of Obstetrics & Gynecology, Pusan National University Hospital, Busan 49241, Korea
| | - Jung-Hye Choi
- Department of Life and Nanopharmaceutical Sciences and Department of Oriental Pharmacy, Kyung Hee University, Seoul 02447, Korea
| | - Tae-Wook Chung
- Department of Korean Medical Science, School of Korean Medicine and Healthy Aging Korean Medical Research Center, Pusan National University, Yangsan 50612, Korea
| | - Ki-Tae Ha
- Department of Korean Medical Science, School of Korean Medicine, Healthy Aging Korean Medical Research Center and Graduate Training Program of Korean Medicine for Healthy-aging, Pusan National University, Yangsan 50612, Korea
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15
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Pathogenesis of deep endometriosis. Fertil Steril 2017; 108:872-885.e1. [DOI: 10.1016/j.fertnstert.2017.08.036] [Citation(s) in RCA: 125] [Impact Index Per Article: 17.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2017] [Revised: 08/22/2017] [Accepted: 08/28/2017] [Indexed: 12/16/2022]
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16
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Carrarelli P, Funghi L, Ciarmela P, Centini G, Reis FM, Dela Cruz C, Mattei A, Vannuccini S, Petraglia F. Deep Infiltrating Endometriosis and Endometrial Adenocarcinoma Express High Levels of Myostatin and Its Receptors Messenger RNAs. Reprod Sci 2017; 24:1577-1582. [DOI: 10.1177/1933719117698579] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Affiliation(s)
- Patrizia Carrarelli
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Lucia Funghi
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Pasquapina Ciarmela
- Department of Experimental and Clinical Medicine, Università Politecnica delle Marche, Ancona, Italy
- Department of Information Engineering, Università Politecnica delle Marche, Ancona, Italy
| | - Gabriele Centini
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Fernando M. Reis
- Division of Human Reproduction, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Cynthia Dela Cruz
- Division of Human Reproduction, Universidade Federal de Minas Gerais, Belo Horizonte, Brazil
| | - Alberto Mattei
- Division of Obstetrics and Gynecology, Careggi University Hospital, Florence, Italy
| | - Silvia Vannuccini
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
| | - Felice Petraglia
- Department of Molecular and Developmental Medicine, Obstetrics and Gynecology, University of Siena, Siena, Italy
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Wu J, Xie H, Yao S, Liang Y. Macrophage and nerve interaction in endometriosis. J Neuroinflammation 2017; 14:53. [PMID: 28288663 PMCID: PMC5351283 DOI: 10.1186/s12974-017-0828-3] [Citation(s) in RCA: 87] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Accepted: 02/28/2017] [Indexed: 12/28/2022] Open
Abstract
Dysregulation of the immune system in endometriotic milieus has been considered to play a pivotal role in the pathogenesis of endometriosis. Macrophage recruitment and nerve fiber infiltration are the two major characteristics of this aberrant immune environment. First, the recruitment of macrophages and their polarization phenotype within the endometriotic lesion have been demonstrated to facilitate the development and maintenance of endometriosis. M1 phenotype of macrophages has the capacity to secrete multiple cytokines for inflammatory response, while M2 macrophage possesses an opposite property that can mediate the process of immunosuppression and neuroangiogenesis. Upon secretion of multiple abnormal signal molecules by the endometriotic lesion, macrophages could alter their location and phenotype. These changes facilitate the accommodation of the aberrant microenvironment and the exacerbation of disease progression. Second, the infiltration of nerve fibers and their abnormal distribution are proved to be involved in the generation of endometriosis-associated pain and inflammatory response. An imbalance in sensory and sympathetic innervation and the abnormal secretion of different cytokines could mediate neurogenesis and subsequent peripheral neuroinflammation in endometriosis. Although endometriosis creates an inflammatory milieu promoting macrophage infiltration and an imbalanced innervation, interaction between macrophages and nerve fibers in this process remains unknown. The aim of this review is to highlight the role of macrophage and nerve interaction in endometriosis, where macrophage recruitment and neurogenesis can be the underlying mechanism of neuroinflammation and pathogenesis of endometriosis.
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Affiliation(s)
- Jinjie Wu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510089 China
| | - Hongyu Xie
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, 510089 China
| | - Shuzhong Yao
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, No. 58, the 2nd Zhongshan Road, Yuexiu District, Guangzhou, 510080 Guangdong Province China
| | - Yanchun Liang
- Department of Obstetrics and Gynecology, First Affiliated Hospital of Sun Yat-sen University, No. 58, the 2nd Zhongshan Road, Yuexiu District, Guangzhou, 510080 Guangdong Province China
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Izumi G, Koga K, Takamura M, Makabe T, Nagai M, Urata Y, Harada M, Hirata T, Hirota Y, Fujii T, Osuga Y. Mannose receptor is highly expressed by peritoneal dendritic cells in endometriosis. Fertil Steril 2017; 107:167-173.e2. [DOI: 10.1016/j.fertnstert.2016.09.036] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2016] [Revised: 09/19/2016] [Accepted: 09/19/2016] [Indexed: 12/14/2022]
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19
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Li Z, Liu H, He Z, Zhang G, Lang J. Effects of cisplatin and letrozole on surgically induced endometriosis and comparison of the two medications in a rat model. Eur J Pharm Sci 2016; 93:132-40. [PMID: 27481456 DOI: 10.1016/j.ejps.2016.07.018] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 07/27/2016] [Accepted: 07/28/2016] [Indexed: 01/07/2023]
Abstract
This study was to investigate the effects of cisplatin (CDDP) and letrozole on surgically induced endometriosis and comparison of the two drugs in a rat model. Endometriosis was surgically induced by autologous transplantation of endometrial pieces. Thirty model rats were divided into three groups, randomly. Group 1 (n=10) served as control and received no medication. Group 2 (n=10) received 0.2mg/kg/day of oral letrozole. Group 3 (n=10) received 35mg/m(2) CDDP via peritoneal perfusion every four days. All the rats were treated for 24days. The growth and histologic score of the implants were evaluated. The proliferation- and angiogenesis-associated proteins were assessed using immunohistochemistry and western blotting. The serum sex hormones were assayed using ELISA. After the medication, the growth and histologic score of the implants were significantly lower in the 2 and 3 groups than in the control group. The protein expressions of vascular endothelial growth factor (VEGF), aromatase P450 (P450arom), transforming growth factor-beta (TGF-β), and matrix metalloproteinase (MMP)-2, were significantly lower in groups 2 and 3 than in the control group. Further, the P450arom level was lower in the letrozole group than in the CDDP group. The TGF-β and MMP-2 levels were lower in the CDDP group than in the letrozole group. Serum T level was significantly higher in the letrozole group, and serum E2 level was lower in the letrozole group. In conclusion, cisplatin and letrozole caused similar regression of the implants in the endometriosis model rats. But their effects on the proliferation- and angiogenesis-associated protein expressions and the serum sex hormone levels were different. Cisplatin and letrozole might cause the effects in the endometriotic foci through different mechanism.
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Affiliation(s)
- Zhanfei Li
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking City 100005, China
| | - Huibing Liu
- Department of Ultrasonography, Third affiliated hospital, Zhengzhou University, Zhengzhou City, Henan Province 450052, China
| | - Zhengxing He
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking City 100005, China
| | - Guorui Zhang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking City 100005, China
| | - Jinghe Lang
- Department of Obstetrics and Gynecology, Peking Union Medical College Hospital, Peking City 100005, China.
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