Decreased Expression of Cannabinoid Receptors in the Eutopic and Ectopic Endometrium of Patients with Adenomyosis.

Xue Shen,Lu Gan,Jin-Jiao Li,Qian Xu,Hua Duan,Sha Wang

doi:10.1155/2019/5468954

Xue Shen, Lu Gan + Show 4 more

Open Access

https://doi.org/10.1155/2019/5468954

Copy DOI

Abstract

Objective Adenomyosis is a common gynecologic benign disease that may have a life-long negative impact on women. Previous studies have indicated that the endocannabinoid system may participate in the progress of endometriosis. Our research aims to analyze the expression patterns of the typical cannabinoid receptors (CB1 and CB2), the main constituents of the endocannabinoid system, in endometrial samples derived from patients diagnosed as adenomyosis or not. Methods Eutopic and corresponding ectopic endometrium from 45 premenopausal women diagnosed as adenomyosis and normal endometrium from 34 age-matched women lacking evidence of adenomyosis were examined by immunohistochemistry and quantitative real-time polymerase chain reaction (qRT-PCR) to determine the CB1 and CB2 expression levels. Results In either the proliferative or the secretory phase, CB1 and CB2 protein and mRNA levels were both significantly lower in the eutopic and ectopic endometrium of adenomyosis when compared with normal endometrium. For women with adenomyosis, CB1 and CB2 protein and mRNA levels were much lower in the ectopic endometrium than the eutopic in both phases of the cycle. Both CB1 and CB2 protein and mRNA levels were increased during the secretory phase in normal endometrium, while CB1 lost its cyclic variation in the eutopic and ectopic endometrium from patients diagnosed as adenomyosis. Conclusion The decreased expression of CB1 and CB2 in the eutopic and ectopic endometrium from patients diagnosed as adenomyosis suggests that cannabinoid receptors may participate in the pathogenesis of adenomyosis.

Highlights

Adenomyosis is a familiar estrogen-dependent uterine disorder distinguished by a nonmalignant invasion of the bioactive endometrium into the myometrial wall, which may result in abnormal uterine bleeding, dysmenorrhea, and subfertility
Given that the uterus means a lot to women, medical therapy causes a big effect in the management of adenomyosis, and the rationale for it rests on the pathogenetic mechanisms of adenomyosis, which have much in common with endometriosis [4]
The cannabinoid receptor 1 (CB1) staining in the ectopic endometrium was less intense than that in the eutopic endometrium in the adenomyosis group (Figures 1(j) and 1(k))

Summary

Introduction

Adenomyosis is a familiar estrogen-dependent uterine disorder distinguished by a nonmalignant invasion of the bioactive endometrium into the myometrial wall, which may result in abnormal uterine bleeding, dysmenorrhea, and subfertility. This condition affects approximately 20% of women of reproductive age and shows an increased incidence among women with infertility [1, 2]. The enzymes involved in those processes are endocannabinoid metabolic enzymes, among which the Nacyl-phosphatidylethanolamine- (NAPE-) hydrolyzing phospholipase D (NAPE-PLD) and the fatty acid amide hydrolase (FAAH) are in charge of the biosynthesis and degradation of AEA, respectively; the sn-1 selective diacylglycerol lipase (DAGL) and the monoacylglycerol lipase (MAGL) are responsible for the formation and hydrolyzation of 2-AG, respectively [7, 8]

Methods

Results

Conclusion