The endometrial stem cell markers notch-1 and numb are associated with endometriosis

Reprod Biomed Online. 2018 Mar;36(3):294-301. doi: 10.1016/j.rbmo.2017.11.010. Epub 2017 Dec 28.


Previous studies reported increased expression of the notch pathway-associated protein Musashi-1 in endometriosis. This case-control study investigates an association of the endometrial stem cell markers notch-1 and numb with endometriosis. Fifty-one endometriosis patients and 76 controls were recruited in the IVF unit and tertiary endometriosis referral centre of a university hospital. All subjects underwent transcervical endometrial biopsy and diagnostic laparoscopy. Expression of endometrial notch-1 and numb was assessed by immunostaining and correlated with clinical data. Association of stem-cell-marker expression with the presence of endometriosis was evaluated. Numb expression in the luminal epithelium was significantly higher in eutopic endometrium of endometriosis patients compared with controls (20.5% versus 16.5%, P = 0.033). Numb-positive single stromal cells were less frequent in endometrioma patients compared with other forms of endometriosis (0.3 versus 0.5 cells/visual field; P = 0.028). Notch-1 expression in endometrial glands was significantly higher in patients with deep infiltrating endometriosis compared with controls (39.1% versus 21.8%; P = 0.045). We conclude that stem cell markers notch-1 and numb of eutopic endometrium are associated with endometriosis and its clinical presentations, supporting the stem cell hypothesis of endometriosis. These findings could help develop promising research strategies applying endometrial stem cells as novel tools.

Keywords: Adult stem cells; Endometriosis; Endometrium; Notch; Numb.

MeSH terms

  • Adult
  • Biomarkers / metabolism*
  • Case-Control Studies
  • Endometriosis / metabolism*
  • Endometriosis / pathology
  • Endometrium / cytology
  • Endometrium / metabolism*
  • Female
  • Fertilization in Vitro
  • Gene Expression Regulation
  • Humans
  • Membrane Proteins / metabolism*
  • Nerve Tissue Proteins / metabolism*
  • Receptor, Notch1 / metabolism*
  • Stem Cells / cytology
  • Stem Cells / metabolism*


  • Biomarkers
  • Membrane Proteins
  • NOTCH1 protein, human
  • Nerve Tissue Proteins
  • Numb protein, human
  • Receptor, Notch1