Are the alterations observed in the endometriotic cells, such as progesterone resistance, already present in the eutopic endometrium or acquired in the ectopic location?
The response to decidualization with progesterone and cyclic AMP for up to 28 days was compared in different endometrial stromal cell (EnSC) lines established from samples of endometriomas (eEnSC), eutopic endometrium from women with endometriosis (eBEnSC), endometrial tissue from healthy women (BEnSC) and menstrual blood from healthy donors (mEnSC).
Usual features of decidualized cells, such as changes in cell morphology and expression of prolactin, were similarly observed in the three types of eutopic EnSC studied, but not in the ectopic cells upon decidualization. Among the phenotypic markers analysed, CD105 was down-regulated under decidualization in all cell types (mEnSC, P = 0.005; BEnSC, P = 0.029; eBEnSC, P = 0.022) except eEnSC. mEnSC and BEnSC underwent apoptosis during decidualization, whereas eBEnSC and eEnSC were resistant to the induction of cell death. Lastly, migration studies revealed that mEnSC secreted undetermined factors during decidualization that inhibited cell motility, whereas eEnSC showed a significantly lower ability to produce those migration-regulating factors (P < 0.0001, P < 0.001 and P = 0.0013 for the migration of mEnSC at 24, 48 and 72 h, respectively; P < 0.0001 for the migration of eEnSC at all times studied).
This study provides novel insights into the differences between endometriotic and eutopic endometrial cells and reinforces the idea that the microenvironment in the ectopic location plays additional roles in the acquisition of the alterations that characterize the cells of the endometriotic foci.
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María José Ruiz-Magaña is a Researcher at the Biomedical Research Centre of the University of Granada, Spain. Since she received her PhD in 2011, she has focused on the characterization of endometrial stromal cells and their participation in the development of endometriosis.
It is unknown whether alterations exhibited by endometriotic cells, such as progesterone resistance, are intrinsic to these cells or acquired in the ectopic foci. This study provides evidence that the ectopic microenvironment must further contribute to the acquisition of the changes that characterize the endometriotic cells.
Published online: December 10, 2022
Accepted: December 6, 2022
Received in revised form: October 28, 2022
Received: July 29, 2022Declaration: The authors report no financial or commercial conflicts of interest.
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