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Hum. Reprod. Advance Access originally published online on January 5, 2007
Human Reproduction 2007 22(4):945-952; doi:10.1093/humrep/del493
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Altered apoptosis and proliferation in endometrial stromal cells of women with adenomyosis

Jehn-Hsiahn Yang, Ming-Yih Wu, Chin-Der Chen, Mei-Jou Chen, Yu-Shih Yang and Hong-Nerng Ho1

Department of Obstetrics and Gynecology, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan

1 To whom correspondence should be addressed at: Department of Obstetrics and Gynecology, National Taiwan University Hospital, 7 Chung-Shan South Road, 100, Taipei, Taiwan. Tel: + 886 2 2312 3456 ext. 5161; Fax: + 886 2 2351 7459; E-mail: hnho{at}ha.mc.ntu.edu.tw

BACKGROUND: The eutopic endometrium in a woman suffering from adenomyosis is known to be biologically different from that of healthy women. The aim of this study was to examine the apoptosis and proliferation of eutopic endometrium from women with adenomyosis.

METHODS: We enrolled 23 women with adenomyosis (study group) and 21 without (control group). Eutopic endometrium was obtained and separated into single endometrial stromal cells (ESCs). ESCs were treated in vitro with hydrogen peroxide (H2O2) to examine their apoptosis using a fluorescence-activated cell sorter. Cells were also treated with estradiol (E2), medroxyprogesterone acetate, interleukin (IL)-6, lipopolysaccharide and interferon-{gamma} (IFN-{gamma}) to test their proliferation using a non-radioactive cell proliferation assay.

RESULTS: The percentage of annexin V ( + )/7-amino-actinomycin D ( + ) ESCs was much lower in women with adenomyosis after 24 h culture with and without H2O2 treatment when compared with the control group. ESCs of adenomyosis proliferated more rapidly than those of the control group, whether they were cultured alone or were treated with E2, MPA, IL-6 or IFN-{gamma}. The immunocytochemical Ki-67 labelling index was much more prominent in adenomyotic ESCs than that of the control group (7.7% versus 1.1%, P < 0.001).

CONCLUSIONS: Altered apoptosis and proliferation of eutopic endometrium possibly elucidate some aspects of the pathophysiology of adenomyosis. A high Ki-67 labelling index in immunocytochemistry might be a potential indicator in predicting the occurrence of adenomyosis.

Key words: adenomyosis/apoptosis/endometrial stromal cell/Ki-67/proliferation

Submitted on August 13, 2006; resubmitted on October 19, 2006; resubmitted on November 27, 2006; accepted on December 1, 2006.


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