Decreased Progesterone Receptor B/A Ratio in Endometrial Cells by Tumor Necrosis Factor-Alpha and Peritoneal Fluid from Patients with Endometriosis

• Published in: Yonsei medical journal Vol. 57; no. 6; pp. 1468 - 1474
• Main Authors: Chae, Uisoo, Min, Jin Young, Kim, Sung Hoon, Ihm, Hyo Jin, Oh, Young Sang, Park, So Yun, Chae, Hee Dong, Kim, Chung-Hoon, Kang, Byung Moon
• Format: Journal Article
• Language: English
• Published: Korea (South) Yonsei University College of Medicine 01.11.2016; 연세대학교의과대학
• Subjects: Adult; Ascitic Fluid - metabolism; Case-Control Studies; Cytokines - metabolism; Endometriosis - genetics; Endometriosis - metabolism; Endometriosis - pathology; Endometriosis - physiopathology; Endometrium - abnormalities; Endometrium - metabolism; Endometrium - pathology; Female; Gene Expression; Humans; Immunohistochemistry; Original; Real-Time Polymerase Chain Reaction; Receptors, Progesterone - metabolism; Tumor Necrosis Factor-alpha - metabolism; Uterine Diseases; 의학일반; cytokine; endometrium; Endometriosis; peritoneal fluid; progesterone receptor
• ISSN: 0513-5796; 1976-2437; 1976-2437
• DOI: 10.3349/ymj.2016.57.6.1468

Progesterone resistance is thought to be a major factor that contributes to progression of endometriosis. However, it is not clear what causes progesterone resistance in endometriosis. This study aimed to assess whether cytokines or peritoneal fluid can affect progesterone receptor (PR) expression in endometrial cells and to verify whether PR expression is reduced in endometriosis. The PR-B/A ratio was measured via real-time polymerase chain reaction after in vitro culture, in which endometrial cells were treated with either tumor necrosis factor-alpha (TNF-α), interleukin-1 beta, or peritoneal fluid obtained from women with advanced-stage endometriosis. Immunohistochemistry was performed to compare PR-B expression between eutopic and ectopic endometrial tissues from women with and without advanced-stage endometriosis. The PR-B/A ratio was significantly decreased by treatment with either TNF-α (p=0.011) or peritoneal fluid from women with advanced-stage endometriosis (p=0.027). Immunoreactivity of PR-B expression was significantly lower during the secretory phase than during the proliferative phase in endometrial tissues from control subjects (p<0.001). PR-B expression was significantly reduced in the eutopic endometrium (p=0.031) and ovarian endometrioma (p=0.036) from women with advanced-stage endometriosis compared with eutopic endometrium tissues from control subjects. Progesterone resistance in endometriosis may be caused by proinflammatory conditions in the pelvic peritoneal microenvironment.