Endometrial inhibin/activin beta-B subunit expression is related to decidualization and is reduced in tubal ectopic pregnancy.
J Clin Endocrinol Metab
; 93(6): 2375-82, 2008 Jun.
Article
em En
| MEDLINE
| ID: mdl-18381568
ABSTRACT
CONTEXT Ectopic pregnancy is common but remains difficult to diagnose accurately. There is no serum test to differentiate ectopic from intrauterine gestation. OBJECTIVE:
Our objective was to investigate differential gene expression in decidualized endometrium of ectopic pregnancy.DESIGN:
Tissue and serum analysis informed by microarray study was performed.SETTING:
The study was performed at a large United Kingdom teaching hospital. PATIENTS OR OTHERPARTICIPANTS:
Women undergoing surgical termination of pregnancy (n = 8), evacuation of uterus for miscarriage (n = 6), and surgery for tubal ectopic pregnancy (n = 11) were included in the study. Endometrium was collected from normally cycling women undergoing hysterectomy.INTERVENTIONS:
Decidualized endometrium was subjected to microarray analysis, morphological assessment, and immunohistochemistry. Endometrial stromal fibroblasts were cultured in the presence of decidualizing stimuli. MAIN OUTCOMEMEASURES:
Differential expression of potentially secreted molecules was calculated.RESULTS:
Inhibin/activin beta-B expression was lower in decidualized endometrium from ectopic pregnancies when compared with that of ongoing pregnancies (P < 0.01) or miscarriages (P < 0.01). The localization of the beta-B subunit was more marked in decidualized than nondecidualized stroma. Decidualization of stromal fibroblasts in vitro was associated with increased beta-B expression (P < 0.05). Endometrial stroma of ectopic pregnancies was less decidualized morphologically (P < 0.05), with lower prolactin (P < 0.01) and IGF binding protein-1 (P < 0.005) expression. Serum activin B was lower in ectopic pregnancies (P < 0.005) than in intrauterine pregnancies, whereas there was no difference in progesterone concentrations.CONCLUSIONS:
Despite similar concentrations of progesterone, the endometrium of ectopic pregnancies is less decidualized than intrauterine pregnancies. Expression of the beta-B subunit is related to decidualization and can be detected in the circulation as activin B. Serum activin B concentrations are lower in ectopic pregnancy.
Texto completo:
1
Base de dados:
MEDLINE
Assunto principal:
Implantação do Embrião
/
Gravidez Tubária
/
Subunidades beta de Inibinas
/
Endométrio
Limite:
Adolescent
/
Adult
/
Female
/
Humans
/
Middle aged
/
Pregnancy
Idioma:
En
Ano de publicação:
2008
Tipo de documento:
Article