Is neonatal uterine bleeding responsible for early-onset endometriosis?
Kanae Ogawa1, Khaleque N Khan2,3, Haruo Kuroboshi1
1Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto, Japan.
Reproductive Biology and Endocrinology : RB&E
|June 19, 2023
Summary
Neonatal uterine blood (NUB) does not appear to cause early-onset endometriosis. Neonatal endometria show proliferative activity but less immune cell infiltration, potentially allowing survival of cells in the pelvis.
Area of Science:
- Reproductive biology
- Developmental biology
- Gynecology
Background:
- Hypothesized origin of early-onset endometriosis from endometrial mesenchymal stem cells (eMSCs) in neonatal uterine blood (NUB).
- Lack of mechanistic understanding linking NUB/neonatal endometrium to early-onset endometriosis.
Purpose of the Study:
- To clarify the mechanistic link between NUB/neonatal endometrium and the development of early-onset endometriosis.
Main Methods:
- Analysis of postmortem neonatal endometria (n=15) and NUB (n=18) for biological markers, including eMSCs.
- Immunohistochemical analysis of neonatal endometria for steroid receptors, decidualization markers, proliferation, vascularity, immune cells, and eMSC markers.
- Investigation of eMSCs and/or endometrial cells in NUB using cell transfer and immunocytochemistry.
Main Results:
- Neonatal endometria exhibited variable ER/PGR expression, decidual markers, and significant proliferative/angiogenic activity.
- Glycodelin-A showed moderate to strong expression in both neonatal and adult endometria.
- Significantly lower infiltration of CD56+, CD45+, and CD68+ immune cells in neonatal endometria compared to adult endometria.
- No eMSCs or endometrial cells were detected in NUB; however, some eMSC phenotypes (CD90/CD105) were found in neonatal endometria.
Conclusions:
- No evidence found supporting NUB's role in early-onset endometriosis.
- Reduced immunocompetent cell accumulation in neonatal endometria may facilitate survival of ER+/PGR+ cells in the pelvis.
- Further research with larger sample sizes and advanced techniques is needed to validate the NUB hypothesis and its significance.
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