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Is neonatal uterine bleeding responsible for early-onset endometriosis?
Ogawa, Kanae; Khan, Khaleque N; Kuroboshi, Haruo; Koshiba, Akemi; Shimura, Koki; Tajiri, Tatsuro; Fumino, Shigehisa; Fujita, Hiroyuki; Okubo, Tomoharu; Fujiwara, Yoichiro; Horiguchi, Go; Teramukai, Satoshi; Fujishita, Akira; Itoh, Kyoko; Guo, Sun-Wei; Kitawaki, Jo; Mori, Taisuke.
Afiliação
  • Ogawa K; Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Khan KN; Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. nemokhan@koto.kpu-m.ac.jp.
  • Kuroboshi H; The Clinical and Translational Research Center, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan. nemokhan@koto.kpu-m.ac.jp.
  • Koshiba A; Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Shimura K; Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Tajiri T; Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Fumino S; Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Fujita H; Department of Pediatric Surgery, Faculty of Medical Sciences, Kyushu University, Fukuoka, Japan.
  • Okubo T; Department of Pediatric Surgery, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Fujiwara Y; Japanese Red Cross Society Kyoto Daini Hospital, Kyoto, Japan.
  • Horiguchi G; Japanese Red Cross Society Kyoto Daiichi Hospital, Kyoto, Japan.
  • Teramukai S; Kyoto City Hospital, Kyoto, Japan.
  • Fujishita A; Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Itoh K; Department of Biostatistics, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Guo SW; Department of Gynecology, Saiseikai Nagasaki Hospital, Nagasaki, Japan.
  • Kitawaki J; Department of Pathology and Applied Neurobiology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
  • Mori T; Shanghai Obstetrics and Gynecology Hospital, Fudan University, Shanghai, China.
Reprod Biol Endocrinol ; 21(1): 56, 2023 Jun 19.
Article em En | MEDLINE | ID: mdl-37337237
BACKGROUND: It has been hypothesized that the origin of early-onset endometriosis could be from endometrial mesenchymal stem cells (eMSCs) in neonatal uterine blood (NUB). There is no information on the possible mechanistic basis linking an association between NUB/neonatal endometrium and development of early-onset endometriosis. In this study we performed a series of experiments to clarify the mechanistic link between NUB and/or neonatal endometrium and development of early-onset endometriosis. METHODS: We retrospectively collected postmortem neonatal endometria (n = 15) and prospectively collected NUB (n = 18) of female babies for the analysis of different biological markers including eMSCs. Immunohistochemical analysis of neonatal endometria was performed to examine the expression patterns of ovarian steroid receptors (ER/PGR), decidualization (prolactin, IGFBP1), pre-decidualization (Glycodelin A, α-SMA), proliferation (Ki-67 index), vascularity (CD31 + cells), immunocompetent CD68+, CD45+, CD56 + cells and some putative markers of eMSCs. Cell transfer method and immunocytochemistry were used to investigate the eMSCs and/or endometrial cells in NUB. RESULTS: Immunohistochemical analysis of postmortem neonatal endometria revealed variable staining response to ER/PGR, decidual markers, and substantial proliferative and angiogenic activity. A moderate to strong immunoexpression of Glycodelin-A was found in both neonatal and adult endometria. The tissue infiltration of CD56+, CD45 + and CD68 + immunocompetent cells was significantly low in neonatal endometria than that in adult endometria (p = 0.0003, p < 0.0001, p = 0.034, respectively). No eMSCs or even endometrial cells were detected in NUB. However, a variable expression of some phenotypes of eMSCs (CD90/CD105) was found in neonatal endometria. CONCLUSIONS: Based on our serial experiments we did not find any supporting evidence for the role of NUB in early-onset endometriosis. Neonatal endometria showed variable expression of ovarian steroid receptors, decidualization, and a substantial amount of proliferative and angiogenic activity. As an alternative mechanism, a significantly less tissue accumulation of immunocompetent cells in neonatal endometria may explain the survival of ER + and PGR + cells should they make entry into the pelvis and consequent development of early endometriosis with the onset of ovarian function. Future study with large sample size and application of modified technological tools is warranted to test the NUB hypothesis and to clarify their biological or clinical significance. TRIAL REGISTRATION: not applicable.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Endometriose Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Endometriose Tipo de estudo: Observational_studies / Risk_factors_studies Limite: Female / Humans Idioma: En Ano de publicação: 2023 Tipo de documento: Article