Abstract

Endometriosis are characterized by dense fibrous tissue. Numerous studies have investigated roles of inflammation on the pathophysiology of endometriosis. However, the interplay of inflammation and fibrosis remains to be clarified. Here we show that low levels of interleukin-1β (IL-1β) and tumor necrosis factor-alpha (TNFα) promoted a fibrotic phenotype, whereas high levels of IL-1β and TNFα inactivated the fibrotic phenotype of endometriotic stromal cells (Ectopic-ES). IL-1β 10 pg/mL and TNFα 100 and 1,000 pg/mL had minimal effects, whereas the highest dose of IL-1β (100 pg/mL) significantly decreased collagen gel contraction in Ectopic-ES. Furthermore, in Ectopic-ES, low levels of IL-1β (1 pg/mL) and/or TNFα 10 pg/mL significantly increased Col I mRNA expression, whereas higher doses of IL-1β (10 and/or 100 pg/mL) and/or TNFα (100 and/or 1,000 pg/mL) significantly decreased Col I and/or αSMA mRNA expression and the percentage of cells with Col I + and/or αSMA + stress fibers. In contrast, in either menstrual endometrial stromal cells of patients with endometriosis or those of healthy women, varying doses of IL-1β and/or TNFα had no significant effects on either Col I or αSMA mRNA/protein expression. The present findings bring into question whether we should still continue to attempt anti-inflammatory treatment strategies for endometriosis.

Highlights

  • Endometriosis are characterized by dense fibrous tissue

  • There were no significant differences in the effects of varying doses of IL-1β and TNFα on cell migration, collagen gel contraction, collagen type I (Col I), αSMA and MMP-I mRNA and/or protein expression of Ectopic-ES derived from deep infiltrating endometriosis versus ovarian endometriosis

  • A baboon model of endometriosis showed that the presence of ectopic lesions enhanced expression of matrix metalloproteinase-1 (MMP-1) mRNA of the eutopic endometrium[28]

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Summary

Introduction

Endometriosis are characterized by dense fibrous tissue. Numerous studies have investigated roles of inflammation on the pathophysiology of endometriosis. Numerous studies have investigated the role of immune-mediated chronic inflammation on the pathophysiology of endometriosis[14,15] and attempted to evaluate various anti-inflammatory drugs, including tumor necrosis factor-alpha TNFα inhibitors[16,17,18] and cyclooxygenase-2 (Cox-2) inhibitors[19,20,21], in endometriosis. We investigated the effects of varying doses of IL-1β and/or TNFα (supplementary Note, supplementary Methods, supplementary Results, supplementary Fig. S1) on cell proliferation, cell migration, collagen gel contraction, mRNA and/or protein expression of collagen type I (Col I), matrix metalloproteinase-1 (MMP-1), and alpha smooth muscle actin (αSMA), which are commonly used methods for evaluating fibrosis[4,5,6,7,8,9,10,11,12], in endometriotic and menstrual endometrial stromal cells of patients with endometriosis. We included menstrual endometrial stromal cells of healthy fertile women for comparison

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