Altered transcriptional regulation of cytokines, growth factors, and apoptotic proteins in the endometrium of infertile women with chronic endometritis

Am J Reprod Immunol. 2013 May;69(5):509-17. doi: 10.1111/aji.12076. Epub 2013 Jan 28.

Abstract

Problem: Chronic endometritis (CE) is a poorly investigated and probably underestimated pathology, which may cause abnormal uterine bleeding (AUB), pain, and reproductive failures. Due to undefined symptoms and the normal presence of leukocytes in the endometrial mucosa, diagnosis may be missed. Fluid hysteroscopy is a reliable technique for diagnosing this pathology. Few data exist on the biochemical and paracrine alterations that occur in the endometrium of women diagnosed with CE. The aim of the study was to find molecular modification in endometrium related to CE.

Method of study: Sixteen women with hysteroscopic and histological diagnosis of CE and 10 healthy women as controls were enrolled. We compared the endometrial expression profile of 25 genes encoding proteins involved in the inflammatory response, proliferation, and apoptosis in endometrium during implantation window, using high-throughput real-time RT-PCR.

Results: In women with CE, the endometrial expression of some genes was significantly altered. In particular, IGFBP1, BCL2, and BAX were up-regulated, while IL11, CCL4, IGF1, and CASP8 were down-regulated.

Conclusion: The altered gene endometrial expression may explain the impaired endometrial receptivity and the finding of endometrial hyperplastic lesions in women affected by CE.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Apoptosis / immunology
  • Caspase 8 / genetics
  • Caspase 8 / metabolism
  • Chemokine CCL4 / genetics
  • Chemokine CCL4 / metabolism
  • Chronic Disease
  • Embryo Implantation, Delayed
  • Endometritis / complications
  • Endometritis / diagnosis
  • Endometritis / immunology*
  • Endometrium / immunology
  • Endometrium / metabolism*
  • Female
  • Gene Expression Profiling
  • Gene Expression Regulation / immunology
  • High-Throughput Screening Assays
  • Humans
  • Hysteroscopy
  • Infertility, Female / etiology
  • Infertility, Female / prevention & control*
  • Insulin-Like Growth Factor Binding Protein 1 / genetics
  • Insulin-Like Growth Factor Binding Protein 1 / metabolism
  • Insulin-Like Growth Factor I / genetics
  • Insulin-Like Growth Factor I / metabolism
  • Interleukin-11 / genetics
  • Interleukin-11 / metabolism
  • Proto-Oncogene Proteins c-bcl-2 / genetics
  • Proto-Oncogene Proteins c-bcl-2 / metabolism
  • bcl-2-Associated X Protein / genetics
  • bcl-2-Associated X Protein / metabolism

Substances

  • Chemokine CCL4
  • IGF1 protein, human
  • IGFBP1 protein, human
  • Insulin-Like Growth Factor Binding Protein 1
  • Interleukin-11
  • Proto-Oncogene Proteins c-bcl-2
  • bcl-2-Associated X Protein
  • Insulin-Like Growth Factor I
  • Caspase 8