title: Medical Therapies for Endometriosis Differentially Inhibit Stem Cell Recruitment.
abstract: To determine the effect of the 3 well-known endometriosis treatments on stem cell recruitment to endometriotic lesions.
  
  
  
  C57BL/6 mice (aged 8 weeks, n = 20) underwent bone marrow transplant following submyeloablation with 5-fluorouracil using 20 × 106bone marrow stem cells from green fluorescent protein (GFP) mice. Two weeks after transplantation, experimental endometriosis was created in mice by suturing segments of the uterine horn into the peritoneal cavity. Mice were then randomized to receive treatment with medroxyprogesterone acetate (MPA), leuprolide acetate (Gonadotrophin-Releasing Hormone Analogue [GnRHa]), letrozole, or vehicle control (dimethyl sulfoxide). After 3 weeks of treatment, the mice were killed and the endometriosis lesions evaluated.
  
  
  
  All 3 treatments resulted in a significant reduction in lesion volume and weight. Estrogen deprivation using GnRHa or letrozole resulted in greater lesion regression than the progestin MPA. The GFP+/CD45-bone marrow-derived stem cells (BMDSCs) engrafted the lesions of endometriosis. Estrogen deprivation using GnRHa or letrozole significantly reduced BMDSC engraftment in the endometriosis lesions. MPA failed to significantly reduce stem cell number in endometriosis.
  
  
  
  The superiority of estrogen deprivation over progestin therapy in depriving the lesions of stem cells may have implications for the long-term treatment of endometriosis. Reduced stem cell engraftment is likely to result in long-term regression of the lesions, whereas progestins may only prevent their growth acutely.
authors.affiliation: 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Gulcin Sahin
authors.initials: GS
authors.lastname: Ersoy
authors.affiliation: 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Masoumeh Majidi
authors.initials: MM
authors.lastname: Zolbin
authors.affiliation: 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Emine
authors.initials: E
authors.lastname: Cosar
authors.affiliation: 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Ramanaiah
authors.initials: R
authors.lastname: Mamillapalli
authors.affiliation: 1 Department of Obstetrics, Gynecology and Reproductive Sciences, Yale School of Medicine, New Haven, CT, USA.
authors.forename: Hugh S
authors.initials: HS
authors.lastname: Taylor
mesh_terms: D000818:Animals; D018931:Antineoplastic Agents, Hormonal / Q000008:administration & dosage / Q000627:therapeutic use*; D016026:Bone Marrow Transplantation; D004195:Disease Models, Animal; D004715:Endometriosis / Q000188:drug therapy*; D004717:Endometrium / Q000187:drug effects; D005260:Female; D000077289:Letrozole; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use*; D017258:Medroxyprogesterone Acetate / Q000008:administration & dosage / Q000627:therapeutic use*; D051379:Mice; D008810:Mice, Inbred C57BL; D009570:Nitriles / Q000008:administration & dosage / Q000627:therapeutic use*; D013234:Stem Cells / Q000187:drug effects*; D014230:Triazoles / Q000008:administration & dosage / Q000627:therapeutic use*
chemical_list: D018931:Antineoplastic Agents, Hormonal; D009570:Nitriles; D014230:Triazoles; D000077289:Letrozole; D017258:Medroxyprogesterone Acetate; D016729:Leuprolide
keywords: endometriosis; letrozole; leuprolide; medroxyprogesterone acetate; stem cells