Vascular smooth muscle cell proliferation in arterioles of the human endometrium
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This study found reduced vascular smooth muscle cell proliferation in endometrial spiral arterioles during the secretory phase in women with menorrhagia, suggesting a potential role in the condition.
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Abstract
Menorrhagia affects approximately 15% of all women, often without identifiable cause. Endometrial spiral arterioles are believed to play a major role in controlling menstruation, and are a major site of menstrual loss. We postulate that alterations in the growth and development of spiral arterioles, particularly the vascular smooth muscle cells (VSMC), may contribute to menorrhagia. We examined VSMC proliferation around endometrial arterioles in control and menorrhagic tissues and the possible roles of transforming growth factor beta (TGF-beta) and endothelin in this process. Proliferating VSMC were located immuno-histochemically, then evaluated using computer-aided image analysis. VSMC proliferation was low and constant during the early stages of the menstrual cycle, increasing at the mid to late secretory stages (P < 0.002). Menorrhagic women had significantly reduced VSMC proliferation in their spiral arterioles at the mid and late secretory stages (P < 0.02). VSMC around straight arterioles proliferated at similar rates across the cycle, apart from a significant decrease in VSMC proliferation in menorrhagic women at the late secretory stage (P < 0.002). Endothelin concentrations decreased significantly in the epithelium of menorrhagic women (P = 0.05), while TGF-beta demonstrated no significant differences in the mid to late secretory tissues studied. The results indicate a significant functional difference between the spiral arterioles of control and menorrhagic women that may play a role in menorrhagia, while leaving the roles of endothelin and TGF-beta undetermined.
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- Uterine bleeding: how understanding endometrial physiology underpins menstrual health 2022
- Platelet-derived growth factor BB is reduced in endometrial endothelial cells of women with abnormal uterine bleeding–endometrial disorder 2022
- The Menstrual Endometrium: From Physiology to Future Treatments 2022
- From menarche to menopause, heavy menstrual bleeding is the underrated compass in reproductive health 2022
- Transforming Growth Factor (TGF) β and Endometrial Vascular Maturation 2021
- Physiology of the Endometrium and Regulation of Menstruation 2020
- Endometrial vascular development in heavy menstrual bleeding: altered spatio-temporal expression of endothelial cell markers and extracellular matrix components 2017
- Menstrual physiology: implications for endometrial pathology and beyond 2015
- Altered vascular smooth muscle cell differentiation in the endometrial vasculature in menorrhagia 2014
- Hysterectomy and levonorgestrel-releasing intrauterine system in the treatment of menorrhagia : a 10-year randomized comparative trial 2012
- Steroid regulation of menstrual bleeding and endometrial repair 2012
- Progesterone: a pivotal hormone at menstruation 2011
- Cortisol Inactivation by 11β-Hydroxysteroid dehydrogenase-2 May Enhance Endometrial Angiogenesis via Reduced Thrombospondin-1 in Heavy Menstruation 2009
- Endometrial Angiogenesis, Vascular Maturation, and Lymphangiogenesis 2008
- Reduced levels of VEGF-A and MMP-2 and MMP-9 activity and increased TNF-α in menstrual endometrium and effluent in women with menorrhagia 2006
- Endocrine Regulation of Menstruation 2005
- Endocrine Regulation of Menstruation 2005
- The Vascular System in the Endometrium: Introduction and Overview 2001
- Regulation of angiogenesis in the endometrium 2001
- Perivascular smooth muscle -actin is reduced in the endometrium of women with progestin-only contraceptive breakthrough bleeding 2000
- Smooth muscle alpha actin and myosin heavy chain expression in the vascular smooth muscle cells surrounding human endometrial arterioles 1999
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