Abstract

BackgroundIt has been previously suggested that angiogenesis occurs during the menstrual cycle. Moreover, a rise in uterine blood flow is largely maintained by vasodilatation and substantial increases in angiogenesis. It is known that estradiol (E2) and progesterone (P4) are involved in angiogenesis. Recently, endothelial progenitor cells (EPCs) were found to be involved in neovascularization; however, their roles in uterine neovascularization have not been well characterized. We hypothesized that E2- or P4-mediated EPC proliferation plays important roles in uterine neovascularization during the menstrual cycle.MethodsThe number of EPCs in peripheral blood from subjects in the menstrual phase (n = 12), follicular phase (n = 8), and luteal phase (n = 16), was measured using flow cytometry. Peripheral blood mononuclear cells (PBMCs) were cultured for seven days with or without 17beta-estradiol (E2beta) or P4, followed by assessment of EPC proliferation based upon the uptake of acetylated low density lipoprotein (LDL) and lectin. The expression of estrogen receptor (ER) or progesterone receptor (PR) in EPCs was also evaluated using real-time PCR.ResultsE2beta and P4 significantly increased the proliferation of EPCs derived from the peripheral blood of subjects in menstrual phase, but not subjects in the luteal phase. In addition, the expression level of ERalpha was markedly higher than ERbeta in EPCs derived from women in menstrual phase.ConclusionsEPC proliferation is induced during the menstrual phase and proliferation can be affected by estrogen through ERalpha activation.

Highlights

  • It has been previously suggested that angiogenesis occurs during the menstrual cycle

  • Detection of Circulating EPCs (cEPCs) in peripheral blood during the menstrual cycle The number of cEPCs in the peripheral blood obtained from subjects in the menstrual cycle was significantly

  • low density lipoprotein (LDL)/Lectin assay of cells cultured for seven days The number of endothelial progenitor cells (EPCs) that were LDL+/lectin+ derived from the peripheral blood of subjects in the luteal phase was significantly increased on the seventh day of culture (481.2 ± 91.2 cells/well) compared to the menstrual phase (227.1 ± 26.5 cells/well; p < 0.05; Figure 3B)

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Summary

Introduction

It has been previously suggested that angiogenesis occurs during the menstrual cycle. Endothelial progenitor cells (EPCs) were found to be involved in neovascularization; their roles in uterine neovascularization have not been well characterized. We hypothesized that E2- or P4-mediated EPC proliferation plays important roles in uterine neovascularization during the menstrual cycle. Angiogenesis in female reproductive organs, including the uterus, corpus luteum, and placenta, is essential for implantation and is critical for the dramatic (30-50 fold) elevation of uterine blood flow during pregnancy [1,2]. Serum E2 and P4 concentrations are very low during the early follicular phase [12] During this phase, serum estrogen levels rise in parallel to the growth of follicle size and granulosa cells. The effects of these hormones and their interactions in reproductive organs remain unclear, especially in vasculogenesis

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