Potential role of endometrial stem/progenitor cells in the pathogenesis of early-onset endometriosis

C E Gargett, Caroline E. Gargett, K E Schwab, Kjiana E. Schwab, Schwab KE, J J Brosens, Brosens JJ, Jan J. Brosens, Puttemans P, P Puttemans, Patrick Puttemans, Benagiano G, G Benagiano, Giuseppe Benagiano, Ivo Brosens, I Brosens, Brosens I
Molecular human reproduction · 2014 · vol. 20(7) , pp. 591–598 · doi:10.1093/molehr/gau025 · PMID:24674992 · W2095849999
Review OA: bronze CC0 ⤵ 123 in-corpus citations
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This review proposes that endometrial stem/progenitor cells shed during neonatal uterine bleeding may initiate early-onset endometriosis, proliferating under estrogen influence during puberty.

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Abstract

The pathogenesis of early-onset endometriosis has recently been revisited, sparked by the discovery of endometrial stem/progenitor cells and their possible role in endometriosis, and because maternal pregnancy hormone withdrawal following delivery induces uterine bleeding in the neonate. The neonatal uterus has a large cervix to corpus ratio which is functionally blocked with mucous, supporting the concept of retrograde shedding of neonatal endometrium. Only 5% show overt bleeding. Furthermore, the presence of endometriosis in pre-menarcheal girls and even in severe stage in adolescents supports the theory that early-onset endometriosis may originate from retrograde uterine bleeding soon after birth. Endometrial stem/progenitor cells have been identified in menstrual blood suggesting that they may also be shed during neonatal uterine bleeding. Thus, we hypothesized that stem/progenitor cells present in shedding endometrium may have a role in the pathogenesis of early-onset endometriosis through retrograde neonatal uterine bleeding. During the neonatal and pre-pubertal period, shed endometrial stem/progenitor cells are postulated to survive in the pelvic cavity in the absence of circulating estrogens supported by niche cells also shed during neonatal uterine bleeding. According to this hypothesis, during thelarche, under the influence of rising estrogen levels, endometrial stem/progenitor cells proliferate and establish ectopic endometrial lesions characteristic of endometriosis. This New Research Horizon review builds on recent discussions on the pathogenesis of early-onset endometriosis and raises new avenues for research into this costly condition.

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Condition tags

endometriosis

MeSH descriptors

Adult Stem Cells Endometriosis Endometrium Adult Stem Cells Adult Stem Cells Endometriosis Endometriosis Endometriosis Endometrium Endometrium Female Female Humans Humans

Citation neighborhood (2-hop)

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

References (75)

Cited by (50)

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License: CC0 · commercial use OK