CHU Clermont-Ferrand, Polyclinique-Hôtel-Dieu, Gynécologie Obstétrique et Médecine de la Reproduction, Boulevard Léon Malfreyt, 63058 Clermont-Ferrand, France.
Hum Reprod. 2009 Dec;24(12):3180-7. doi: 10.1093/humrep/dep306. Epub 2009 Sep 7.
The aim of this study was to investigate HOXA-10 expression in endometrium from infertile patients with different forms of endometriosis; with uterine fibromas, or with unexplained infertility and from normal fertile women.
Expression levels of HOXA-10 mRNA and protein in endometrium were measured during the mid-secretory phase. This study utilized laser capture microdissection, real-time RT-PCR and immunohistochemistry.
HOXA-10 mRNA and protein expression levels in endometrial stromal cells were significantly lower in infertile patients with different types of endometriosis (deep infiltrating endometriosis, ovarian endometriosis and superficial peritoneal endometriosis), with uterine myoma, and unexplained infertility patients as compared with healthy fertile controls. HOXA-10 mRNA expression levels of microdissected glandular epithelial cells were significantly lower than those of microdissected stromal cells, without significant differences among the different groups. No protein expression was detected in glandular epithelial cells. The percentage of patients with altered protein expression of HOXA-10 in stromal cells were significantly higher in patients with only superficial peritoneal endometriosis (100%, 20/20, P < 0.05) compared with the other infertile groups (deep infiltrating endometriosis: 72.7%, 16/22; ovarian endometriosis: 70.0%, 14/20; uterine myoma: 68.8%, 11/16; unexplained infertility: 55.6%, 5/9).
The present findings suggested that altered expression of HOXA-10 in endometrial stromal cells during the window of implantation may be one of the potential molecular mechanisms of infertility in infertile patients, particularly in patients with only superficial peritoneal endometriosis. One of the underlying causes of infertility in patients with only superficial endometriosis may be altered expression of HOXA-10 in endometrial stromal cells.
本研究旨在探讨不同类型子宫内膜异位症（深部浸润型子宫内膜异位症、卵巢子宫内膜异位症和浅表腹膜子宫内膜异位症）、子宫肌瘤和不明原因不孕患者以及正常生育女性的子宫内膜中 HOXA-10 的表达情况。
在分泌中期测量子宫内膜中 HOXA-10mRNA 和蛋白的表达水平。本研究采用激光捕获显微切割、实时 RT-PCR 和免疫组织化学方法。
与健康生育对照组相比，不同类型子宫内膜异位症（深部浸润型子宫内膜异位症、卵巢子宫内膜异位症和浅表腹膜子宫内膜异位症）、子宫肌瘤和不明原因不孕患者的子宫内膜间质细胞中 HOXA-10mRNA 和蛋白表达水平显著降低。微切割腺上皮细胞的 HOXA-10mRNA 表达水平明显低于微切割基质细胞，但各组之间无显著差异。腺上皮细胞未检测到蛋白表达。仅浅表腹膜子宫内膜异位症患者（100%，20/20，P<0.05）基质细胞中 HOXA-10 蛋白表达改变的患者比例明显高于其他不孕组（深部浸润型子宫内膜异位症：72.7%，16/22；卵巢子宫内膜异位症：70.0%，14/20；子宫肌瘤：68.8%，11/16；不明原因不孕：55.6%，5/9）。
本研究结果提示，着床窗期间子宫内膜间质细胞中 HOXA-10 的表达改变可能是不孕患者不孕的潜在分子机制之一，尤其是仅存在浅表腹膜子宫内膜异位症的患者。仅存在浅表子宫内膜异位症患者不孕的原因之一可能是子宫内膜间质细胞中 HOXA-10 的表达改变。
