Endometriosis-related infertility is common in women of reproductive age. Progesterone resistance, especially aberrantly expressed progesterone receptor in the eutopic endometrium, is considered as a key causal factor. Our objective is to explore microRNA-mediated mechanism controlling aberrant progesterone receptor expression in infertile women with minimal or mild endometriosis. microRNA Array, combined with Human Gene Expression microarrays, was used to screen eutopic endometrium of infertile women with minimal or mild endometriosis. Bioinformatics analysis predicted that microRNA-196a target the PGR 3′UTR. We studied the relationship between microRNA-196a level and PGR expression in endometrial stromal cells (ESCs). According to mRNAs microarray result, MAPK pathway is activated in eutopic mid-secretory endometrium. The role of MAPK pathway involved regulation of miR-196a on PGR was also investigated. The study was conducted at West China Second University Hospital of Sichuan University. 22 infertile women with r-AFSI-IIendometriosis and 20 disease-free control subjects were enrolled. MiRCURY LNATM microRNA Array(v.18.0)(Exiqon), Human 4×44K Gene Expression Microarrays v2(Agilent), qRT-PCR, cell culture, transfections, luciferase reporter assays, and western bolt were used in this study. 66 differently expressed microRNAs (fold change≥2.00 and p<0.05) were found by microRNA array in eutopic endometrium of infertile women with minimal or mild endometriosis. Among them, the expression of 54 microRNAs were increased, while 12 microRNAs were decreased. Meanwhile, mRNA array screened 357 differently expressed mRNAs (fold change≥2.00 and p<0.05).Among them, 224 mRNAs over-expressed and 133 mRNAs down-expressed. miR-196a was the highest over-expression microRNA, which was confirmed by qRT-PCR. The transfection of ESCs with miR-196a mimics significantly decreased expression of total PGR and PGR-B mRNA levels, while total PGR and PGR-B mRNA expression were up-regulated by miR-196a inhibitor. Luciferase reporter failed to confirm the target regulation of miR-196a on PGR in 293T cell line. Based on mRNA microarray, Western blot confirmed that P-MEK1/2 and P-ERK1/2, the key molecular of MAPK pathway, were upregulated in eutopic endometrium in infertile women with minimal or mild endometriosis. P-MEK1/2 and P-ERK1/2 expression were up-regulated, PGR-A and PGR-B expression were inhibited, and the ratio of PGR-A/PGR-B was up-regulated by miR-196a overexpression in eutopic ESCs. Meanwhile, a specific P-MEK/P-ERK inhibitor, U0126 resulted in upregulation of PGR-A and PGR-B protein, and the downregulation of the protein ratio of PGR-A/PGR-B in ESCs. Aberrantly expressed miR-196a represses PGR expression and upregulate the protein ratio of PGR-A/PGR-B via activation of MAPK pathway in eutopic endometrium of infertile women with minimal or mild endometriosis.
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