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Hum. Reprod. Advance Access published online on July 31, 2006
Human Reproduction, doi:10.1093/humrep/del297
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© The Author 2006. 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
Received February 2, 2006
Revised June 13, 2006
Accepted June 23, 2006

Article

Increased expression of matrix metalloproteinase-9 in the eutopic endometrial tissue of women with endometriosis

T. Collette 1, R. Maheux 2, J. Mailloux 3, and A. Akoum 2 *

1 Centre de Recherche, Hôpital Saint-François d’Assise, Centre Hospitalier Universitaire de Québec, Canada
2 Centre de Recherche, Hôpital Saint-François d’Assise, Centre Hospitalier Universitaire de Québec; Département d’Obstétrique et Gynécologie, Faculté de Médecine, Université Laval, Québec, Canada
3 Département d’Obstétrique et Gynécologie, Faculté de Médecine, Université Laval, Québec, Canada

* To whom correspondence should be addressed.
A. Akoum, E-mail: ali.akoum{at}crsfa.ulaval.ca


  Abstract

BACKGROUND: Endometriosis is a disease where endometrial tissue implants in ectopic locations. Remodelling of the extracellular matrix (ECM) is a prerequisite for the implantation of this tissue to be possible. METHODS: In this study, we detected immunoreactive matrix metalloproteinase-9 (MMP-9) throughout endometrial tissue and identified von Willebrand factor (vWF)-positive endothelial cells, CD45-positive leukocytes, CD3-positive T lymphocytes and CD68-positive macrophages as cells expressing MMP-9 in the stroma. RESULTS: We found an increased expression of MMP-9 in the uterine endometrial tissue of women with endometriosis, as assessed by zymography and enzyme-linked immunosorbent assay (ELISA) (P < 0.05). However, RT-PCR did not show a statistically significant increase in MMP-9 mRNA expression in these tissues (P = 0.14). There was no significant difference between women with and without endometriosis in the expression of tissue inhibitor of MMPs (TIMP)-1, a known natural inhibitor of the pro- and active forms of MMP-9, whether tested by ELISA or by RT-PCR (P = 0.46 and 0.37, respectively). Interestingly, the ratio of MMP-9/TIMP-1 expression was significantly higher in women with endometriosis than in normal women both at the protein and the mRNA levels (P < 0.05). CONCLUSION: These findings make plausible the involvement of MMP-9/TIMP-1 imbalance in the invasiveness of the endometrial tissue of patients with endometriosis and the ectopic development of the disease.

Keywords: endometriosis/endometrium/matrix metalloproteinase-9/tissue inhibitor of matrix metalloproteinase.
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