Abstract

Successful implantation is dependent on the appropriate decidualization of endometrial stromal cells for the establishment of pregnancy in women. Mycobacterial heat shock protein 65 (HSP65) is involved in pathogenesis of the genital tuberculosis (GTB), one of the common causes of infertility in emerging countries. Though implantation failure appears to be the major cause, understanding the status of decidualizaiton process in women diagnosed with GTB has not been thoroughly addressed. We, therefore, explored the effect of HSP65 protein on the endometrial cell metabolism during in vitro decidualization. In order to identify the cellular metabolism of decidual cells with and without HSP65 treatment, proton NMR based characterization of metabolites extracted from cells and culture media were performed. In presence of HSP65, significant reduction in the decidual phenotype of endometrial stromal cells and prolactin expression is suggestive of impairment in decidualization. The intracellular and extracellular metabolic changes in HSP65 treated endometrial stromal cells produced a distinct pattern, reflecting the interaction between the protein and cellular metabolism. HSP65 mediated dysregulation in cellular metabolism is associated with poor decidualization. Besides enriching the present knowledge on metabolic changes underlying stromal cells decidualization, these findings assist in identifying potential molecular causes for decidualization failure in GTB women.

Highlights

  • Genital tuberculosis (GTB) is common in infertile women with increasing prevalence of 5% worldwide[1, 2]

  • Enhanced glucose metabolism in endometrial decidualization[23,24,25], the key regulatory pathways involving the metabolic homeostasis of human endometrial stromal cells (hESC) decidualization process is yet to be unraveled

  • We have reported that compromised LIF mediated signal transducer and activator of transcription 3 (STAT3) signaling in hESC after HSP65 treatment is leading to poor decidualization[4]

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Summary

Introduction

Genital tuberculosis (GTB) is common in infertile women with increasing prevalence of 5% worldwide[1, 2]. The 65 kDa heat shock protein (HSP65), secreted by Mycobacterium tuberculosis during intracellular survival, is one of the major immunologically active antigens and considered to be a diagnostic marker of GTB4. This protein plays an important role in the pathogenesis of tuberculosis[4, 5] and may contribute to the implantation failure in GTB women. Human endometrial stromal cells (hESC) undergo the process of decidualization to mediate harmonized interaction between a receptive endometrium and a functional blastocyst[7]. This study revealed the possible association of dysregulated energy metabolism and amino acid biosynthesis metabolites with repeated implantation failure in dormant GTB women[4]

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