Identification of epidermal growth factor, transforming growth factor-alpha, and epidermal growth factor receptor in surgically induced endometriosis in rats.

The present immunohistochemical studies used polyclonal antibodies specific to epidermal growth factor (EGF), transforming growth factor-alpha (TGF-alpha), and monoclonal antibodies to the extracellular binding domain of EGF receptor to elucidate their presence and cellular distribution in surgically induced endometriosis in the rat. Uterine segments were implanted in the mesenteric region adjacent to a blood vessel for a period of 4-6 weeks. During operative reexploration, the implanted tissues were intact, morphologically similar to the controls, and consisted of a cyst containing clear fluid and associated adhesion formation. All the uterine cell types immunostained with antibody to EGF. The highest immunostaining intensity was associated with inflammatory cells infiltrated among endometrial stromal cells, followed by luminal and glandular epithelial and stromal cells. The cysts consisted of an inner simple columnar epithelium, surrounded by several layers of smooth muscle and connective tissue. The cyst epithelial layer immunostained weakly, while the supporting wall stained moderately. The inflammatory cells found within the cyst cavity immunostained very intensely, comparable to those in the endometrium. The patterns of immunostaining for TGF-alpha and EGF receptor were similar to that observed for EGF. Myometrial smooth-muscle cells and endothelial and smooth-muscle cells of arterioles were also immunostained for EGF, TGF-alpha, and EGF receptor, but with lower intensity than that of the endometrium. These observations suggest that, like normal uterine tissue, endometrial implants produce EGF and TGF-alpha locally and contain receptors for EGF. These results imply a possible paracrine or autocrine role for growth factors in the establishment and/or maintenance of endometriotic tissue.