Endometrial cells from women with endometriosis have increased adhesion and proliferative capacity in response to extracellular matrix components: towards a mechanistic model for endometriosis progression.
BACKGROUND
Endometriosis, classified as the presence of endometrial cells in ectopic sites, is a debilitating disease causing pain and infertility in approximately 10% of women of reproductive age. It is associated with the aberrant expression of extracellular matrix (ECM) components and their receptors, integrins.


METHODS
We analysed the expression of integrins in stromal cells derived from peritoneal, ovarian and deeply infiltrating endometriotic lesions and from endometrium from women with and without endometriosis in vitro, using quantitative immunocytochemistry. The adhesive and proliferative capacity of each of the cell types in response to ECM components was assessed by in vitro assays of cell attachment and DNA synthesis.


RESULTS
We demonstrate that eutopic and ectopic endometrial stromal cells from women with endometriosis exhibit an aberrant integrin profile in vitro compared with stromal cells derived from healthy controls. In addition, the former display increased adhesion and proliferative capacity in response to specific ECM components.


CONCLUSIONS
We propose that the increased adhesive and proliferative potential of cells from endometriotic lesions may be a key feature in the pathogenesis of endometriosis. Furthermore, the elevated responsiveness of eutopic cells from women with endometriosis may contribute to the predisposition of some women to the disease.
Klemmt
Petra A B
PA
Nuffield Department of Obstetrics and Gynaecology, Level 3, The Women's Centre, John Radcliffe Hospital, Oxford OX3 9DU, UK.
Carver
Janet G
JG
Koninckx
Philippe
P
McVeigh
Enda J
EJ
Mardon
Helen J
HJ
D000328:Adult; D002448:Cell Adhesion; D002455:Cell Division; D002460:Cell Line; D024042:Collagen Type I / Q000378:metabolism; D024141:Collagen Type IV / Q000378:metabolism; D004247:DNA / Q000096:biosynthesis; D018450:Disease Progression; D004715:Endometriosis / Q000378:metabolism* / Q000473:pathology*; D004717:Endometrium / Q000378:metabolism* / Q000473:pathology*; D016326:Extracellular Matrix Proteins / Q000378:metabolism*; D005260:Female; D006801:Humans; D066298:In Vitro Techniques; D016023:Integrins / Q000378:metabolism; D007797:Laminin / Q000378:metabolism; D008875:Middle Aged; D017154:Stromal Cells / Q000378:metabolism / Q000473:pathology
D024042:Collagen Type I; D024141:Collagen Type IV; D016326:Extracellular Matrix Proteins; D016023:Integrins; D007797:Laminin; D004247:DNA