Manisa Celal Bayar University Medical Faculty, Manisa, Turkey.
Ginekol Pol. 2020;91(5):240-246. doi: 10.5603/GP.2020.0048.
Endometrial receptivity plays the most important role for successful implantation. Increasing endometrial receptivity may improve infertility and increase Assisted Reproductive Technologies success. The aim of this study was to investigate the effect of exosome specific markers CD63 and CD9 which are promising molecules in the pathogenesis and treatment of many diseases on endometrial receptivity in women with unexplained infertility.
This prospective study was conducted between November 2015 and March 2017. Proliferation and secretion periods of endometrial samples from fertile and infertile cases were collected. The paraffin-embedded tissue sections were stained with hematoxylin-eosin for the immunohistochemical analysis distributions of CD63 and CD9.
The results of this study demonstrated that the CD63 immunoreactivity was higher in both luminal and glandular epithelium of infertile patients when compared with fertile patients during the proliferative phase (p = 0.009, p = 0.008). In the infertile proliferation phase, endometrium CD9 immunoreactivity was rarely detected in both the luminal and glandular epithelium. In the secretion phase of endometrium, CD9 immunoreactivity was mild in fertile patients, the increased immunoreactivity of CD9 was observed in both luminal and glandular epithelium of infertile patients (p = 0.037, p = 0.037).
Increased levels of CD63 in infertile proliferation phase endometrium should represent an unfavorable signaling. Moreover, the increased levels of CD9 in infertile secretion phase endometrium could be used as a biomarker to evaluate endometrial receptivity. These exosome-specific markers can be considered as potential molecular markers of infertility.
子宫内膜容受性对成功着床起着最重要的作用。提高子宫内膜容受性可能改善不孕，并提高辅助生殖技术的成功率。本研究旨在探讨外泌体特异性标志物 CD63 和 CD9 在许多疾病的发病机制和治疗中具有重要作用，对不明原因不孕妇女的子宫内膜容受性的影响。
本前瞻性研究于 2015 年 11 月至 2017 年 3 月进行。收集了肥沃和不孕病例的增殖期和分泌期的子宫内膜样本。对石蜡包埋组织切片进行苏木精-伊红染色，进行 CD63 和 CD9 的免疫组织化学分析分布。
本研究结果表明，与肥沃患者相比，在增殖期，不孕患者的腔上皮和腺上皮的 CD63 免疫反应性均较高（p = 0.009，p = 0.008）。在不孕患者的增殖期子宫内膜中，CD9 免疫反应性在腔上皮和腺上皮中很少检测到。在子宫内膜的分泌期，肥沃患者的 CD9 免疫反应性较弱，不孕患者的腔上皮和腺上皮均观察到 CD9 免疫反应性增强（p = 0.037，p = 0.037）。
不孕患者增殖期子宫内膜中 CD63 水平升高代表不利的信号。此外，不孕患者分泌期子宫内膜中 CD9 水平升高可作为评估子宫内膜容受性的生物标志物。这些外泌体特异性标志物可作为不孕的潜在分子标志物。
