IL-6 Inhibits Invasion in a Murine Model of Endometriosis

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Abstract

Endometriosis is a gynecological inflammatory disorder characterized by the presence of endometrial tissue outside of the uterus. It affects 10-15% of reproductive aged women, causing pelvic pain and infertility. Existing treatments for endometriosis, including invasive and non-invasive therapies, are plagued by treatment resistance and adverse effects. Dissecting molecular mechanisms or signaling pathways that are involved in the pathophysiology of endometriosis may reveal new molecular targets. IL-6 is classically considered an inflammatory cytokine that is highly expressed in endometriosis. Here, we studied the effect of an anti-IL-6R antibody that interferes with the IL-6 signaling pathway in endometriosis. Endometriosis was induced in c57BL/6 female mice that were subsequently treated with either a murine-specific anti-IL-6 receptor monoclonal antibody (15A7) or IgG2b as a control. We found that there was no change in endometriosis lesion number or volume. However, we observed that the lesion attachment to underlying peritoneum was significantly increased after treatment with the 15A7 antibody, indicating a possible effect on invasion. As expected, IL-6 mediated pathways of p38 MAPK and STAT3 in JAK/STAT signaling were decreased in the anti-IL-6R treatment group compared to isotype control group. There were no differences in N-Cadherin and ICAM between groups. IL-6 had a paradoxical role in endometriosis - preventing or limiting invasion and adhesion.
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Abstract

Endometriosis is a gynecological inflammatory disorder characterized by the presence of endometrial tissue outside of the uterus. It affects 10–15% of reproductive aged women, causing pelvic pain and infertility. Existing treatments for endometriosis, including invasive and non-invasive therapies, are plagued by treatment resistance and adverse effects. Dissecting molecular mechanisms or signaling pathways that are involved in the pathophysiology of endometriosis may reveal new molecular targets. IL-6 is classically considered an inflammatory cytokine that is highly expressed in endometriosis. Here, we studied the effect of an anti-IL-6R antibody that interferes with the IL-6 signaling pathway in endometriosis. Endometriosis was induced in c57BL/6 female mice that were subsequently treated with either a murine-specific anti-IL-6 receptor monoclonal antibody (15A7) or IgG2b as a control. We found that there was no change in endometriosis lesion number or volume. However, we observed that the lesion attachment to underlying peritoneum was significantly increased after treatment with the 15A7 antibody, indicating a possible effect on invasion. As expected, IL-6 mediated pathways of p38 MAPK and STAT3 in JAK/STAT signaling were decreased in the anti-IL-6R treatment group compared to isotype control group. There were no differences in N-Cadherin and ICAM between groups. IL-6 had a paradoxical role in endometriosis – preventing or limiting invasion and adhesion. Similar content being viewed by others Data Availability Available with Ramanaiah Mamillapalli and Hugh Taylor. Code Availability Not applicable.

References

Taylor HS, Kotlyar AM, Flores VA. Endometriosis is a chronic systemic disease: clinical challenges and novel innovations. Lancet. 2021;27(10276):839–52. https://doi.org/10.1016/s0140-6736(21)00389-5. Agarwal SK, Chapron C, Giudice LC, et al. Clinical diagnosis of endometriosis: a call to action. Am J Obstet Gynecol. 2019;220(4):354e. 1-354.e12. Saunders PTK, Horne AW. Endometriosis: etiology, pathobiology, and therapeutic prospects. Cell. 2021;27(11):2807–24. https://doi.org/10.1016/j.cell.2021.04.041. Becker CM, Gattrell WT, Gude K, Singh SS. Reevaluating response and failure of medical treatment of endometriosis: a systematic review. Fertil Steril. 2017;108(1):125–36. https://doi.org/10.1016/j.fertnstert.2017.05.004. Wolf J, Rose-John S, Garbers C. Interleukin-6 and its receptors: a highly regulated and dynamic system. Cytokine. 2014;70(1):11–20. https://doi.org/10.1016/j.cyto.2014.05.024. Hirano T, Matsuda T, Turner M, et al. Excessive production of interleukin 6/B cell stimulatory factor-2 in rheumatoid arthritis. Eur J Immunol. 1988;18(11):1797–802. Shahini A, Shahini A. Role of interleukin-6-mediated inflammation in the pathogenesis of inflammatory bowel disease: focus on the available therapeutic approaches and gut microbiome. J Cell Commun Signal. 2023;17(1):55–74. https://doi.org/10.1007/s12079-022-00695-x. Nepal D, Gazeley D. Role of IL-6 and IL-6 targeted therapy in systemic lupus erythematosus. Rheumatology. 2023;62(12):3804–10. https://doi.org/10.1093/rheumatology/kead416. Olive DL, Weinberg JB, Haney AF. Peritoneal macrophages and infertility: the association between cell number and pelvic pathology. Fertil Steril. 1985;44(6):772–7. https://doi.org/10.1016/s0015-0282(16)49036-9. Gazvani R, Templeton A. Peritoneal environment, cytokines and angiogenesis in the pathophysiology of endometriosis. Reproduction. 2002;123(2):217–26. https://doi.org/10.1530/rep.0.1230217. Haney AF, Muscato JJ, Weinberg JB. Peritoneal fluid cell populations in infertility patients. Fertil Steril. 1981;35(6):696–8. https://doi.org/10.1016/s0015-0282(16)45567-6. Tseng JF, Ryan IP, Milam TD, et al. Interleukin-6 secretion in vitro is up-regulated in ectopic and eutopic endometrial stromal cells from women with endometriosis. J Clin Endocrinol Metab. 1996;81(3):1118–22. https://doi.org/10.1210/jcem.81.3.8772585. Li S, Fu X, Wu T, Yang L, Hu C, Wu R. Role of Interleukin-6 and its receptor in endometriosis. Med Sci Monit Aug. 2017;5:23:3801–7. https://doi.org/10.12659/msm.905226. Kang YJ, Jeung IC, Park A, et al. An increased level of IL-6 suppresses NK cell activity in peritoneal fluid of patients with endometriosis via regulation of SHP-2 expression. Hum Reprod. 2014;10(10):2176–89. https://doi.org/10.1093/humrep/deu172. Wu MY, Ho HN, Chen SU, Chao KH, Chen CD, Yang YS. Increase in the production of interleukin-6, interleukin-10, and interleukin-12 by lipopolysaccharide-stimulated peritoneal macrophages from women with endometriosis. Am J Reprod Immunol. 1999;41(1):106–11. https://doi.org/10.1111/j.1600-0897.1999.tb00082.x. Scott LJ. Tocilizumab: a review in rheumatoid arthritis. Drugs. 2017;77(17):1865–79. https://doi.org/10.1007/s40265-017-0829-7. Genentech, Inc. Actemra. 2017. https://www.accessdata.fda.gov/drugsatfda_docs/label/2017/125276s114lbl.pdf. Accessed 2 May 2023. Kaye AG, Siegel R. The efficacy of IL-6 inhibitor tocilizumab in reducing severe COVID-19 mortality: a systematic review. PeerJ. 2020;8:e10322. https://doi.org/10.7717/peerj.10322. Gupta S, Leaf DE. Tocilizumab in COVID-19: some clarity amid controversy. Lancet. 2021;397(10285):1599–601. https://doi.org/10.1016/s0140-6736(21)00712-1. Rosas IO, Bräu N, Waters M, et al. Tocilizumab in hospitalized patients with severe Covid-19 pneumonia. N Engl J Med. 2021;384(16):1503–16. https://doi.org/10.1056/nejmoa2028700. Taskin MI, Gungor AC, Adali E, Yay A, Onder GO, Inceboz U. A humanized anti-Interleukin 6 receptor monoclonal antibody, tocilizumab, for the treatment of endometriosis in a rat model. Reprod Sci. 2016;23(5):662–9. https://doi.org/10.1177/1933719115612134. El-Zayadi AA, Mohamed SA, Arafa M, et al. Anti-IL-6 receptor monoclonal antibody as a new treatment of endometriosis. Immunol Res. 2020;68(6):389–97. https://doi.org/10.1007/s12026-020-09153-5. Lokau J, Kleinegger F, Garbers Y, et al. Tocilizumab does not block interleukin-6 (IL-6) signaling in murine cells. PLoS ONE. 2020;15(5):e0232612. https://doi.org/10.1371/journal.pone.0232612. Rafique A, Martin J, Blome M, Huang T, Ouyang A, Papadopoulos N. AB0037 Evaluation of the binding kinetics and functional bioassay activity of sarilumab and Tocilizumab to the human il-6 receptor (il-6r) alpha. Ann Rheum Dis. 2013;72(Suppl 3):A797–797. https://doi.org/10.1136/annrheumdis-2013-eular.2360. Lee B, Du H, Taylor HS. Experimental murine endometriosis induces DNA methylation and altered gene expression in eutopic endometrium. Biol Reprod. 2009;80(1):79–85. https://doi.org/10.1095/biolreprod.108.070391. Sahin C, Mamillapalli R, Yi KW, Taylor HS. Microrna let-7b: a novel treatment for endometriosis. J Cell Mol Med. 2018;22(11):5346–53. https://doi.org/10.1111/jcmm.13807. Kotlyar AM, Mamillapalli R, Flores VA, Taylor HS. Tofacitinib alters STAT3 signaling and leads to endometriosis lesion regression. Mol Hum Reprod. 2021(4). https://doi.org/10.1093/molehr/gaab016. Parris TZ, Aziz L, Kovács A, et al. Clinical relevance of breast cancer-related genes as potential biomarkers for oral squamous cell carcinoma. BMC Cancer. 2014;14(1):324. https://doi.org/10.1186/1471-2407-14-324. Beliard A, Noël A, Goffin F, Frankenne F, Foidart JM. Adhesion of endometrial cells labeled with 111Indium-tropolonate to peritoneum: a novel in vitro model to study endometriosis. Fertil Steril Mar. 2003;79(Suppl 1):724–9. https://doi.org/10.1016/s0015-0282(02)04819-7. Debrock S, De Strooper B, Vander Perre S, Hill JA, D’Hooghe TM. Tumour necrosis factor-alpha, interleukin-6 and interleukin-8 do not promote adhesion of human endometrial epithelial cells to mesothelial cells in a quantitative in vitro model. Hum Reprod. 2006;21(3):605–9. https://doi.org/10.1093/humrep/dei375. Kyriakis JM, Avruch J. Mammalian mitogen-activated protein kinase signal transduction pathways activated by stress and inflammation. Physiol Rev. 2001;81(2):807–69. Olson JM, Hallahan AR. P38 MAP kinase: a convergence point in cancer therapy. Trends Mol Med. 2004;10(3):125–9. Yang R, Teng H, Xu X, et al. Microarray analysis of microrna deregulation and angiogenesis-related proteins in endometriosis. Genet Mol Res. 2016;15(2):1–8. Yoshino O, Osuga Y, Hirota Y, et al. Possible pathophysiological roles of mitogen-activated protein kinases (MAPKs) in endometriosis. Am J Reprod Immunol. 2004;52(5):306–11. https://doi.org/10.1111/j.1600-0897.2004.00231.x. Zhong Z, Wen Z, Darnell JE Jr. Stat3: a STAT family member activated by tyrosine phosphorylation in response to epidermal growth factor and interleukin-6. Science. 1994;264(5155):95–8. Bollrath J, Phesse TJ, von Burstin VA, et al. Gp130-mediated Stat3 activation in enterocytes regulates cell survival and cell-cycle progression during colitis-associated tumorigenesis. Cancer Cell. 2009;15(2):91–102. Catlett-Falcone R, Landowski TH, Oshiro MM, et al. Constitutive activation of Stat3 signaling confers resistance to apoptosis in human U266 myeloma cells. Immunity. 1999;10(1):105–15. Choi J, Jo M, Lee E, Kim SE, Lee DY, Choi D. Dienogest attenuates STAT3 activation in ovarian endometriotic cysts. Eur J Obstet Gynecol Reprod Biol. 2024;294:217–21. https://doi.org/10.1016/j.ejogrb.2024.01.013. Zhang T, Yang J, Sun Y et al. Interleukin-6 and hypoxia synergistically promote EMT-mediated invasion in epithelial ovarian cancer via the IL-6/STAT3/HIF-1α feedback loop. Anal. Cell. Pathol. 2023;2023. García-Solares J, Dolmans M-M, Squifflet J-L, Donnez J, Donnez O. Invasion of human deep nodular endometriotic lesions is associated with collective cell migration and nerve development. Fertil Steril. 2018;110(7):1318–27. https://doi.org/10.1016/j.fertnstert.2018.08.016. Yang Y-M, Yang W-X. Epithelial-to-mesenchymal transition in the development of endometriosis. Oncotarget. 2017;8(25):41679–89. https://doi.org/10.18632/oncotarget.16472. Polyak K, Weinberg RA. Transitions between epithelial and mesenchymal states: acquisition of malignant and stem cell traits. Nat Rev Cancer. 2009;9(4):265–73. https://doi.org/10.1038/nrc2620. Chen M, Zhou Y, Xu H, et al. Bioinformatic analysis reveals the importance of epithelial-mesenchymal transition in the development of endometriosis. Sci Rep. 2020;10(1). https://doi.org/10.1038/s41598-020-65606-9. Konrad L, Dietze R, Riaz MA, et al. Epithelial–mesenchymal transition in Endometriosis—when does it happen?? J Clin Med. 2020;9(6):1915. https://doi.org/10.3390/jcm9061915. Kalkan U, Biyik I, Simsek S, T-Cadherin E, Cadherin. PR-A, and ER-α levels in deep infiltrating endometriosis. Int J Gynecol Pathol Nov. 2022;1(6):593–9. https://doi.org/10.1097/pgp.0000000000000860. Donnez O, Orellana R, Van Kerk O, Dehoux J-P, Donnez J, Dolmans M-M. Invasion process of induced deep nodular endometriosis in an experimental baboon model: similarities with collective cell migration? Fertil Steril. 2015;104(2):491–e4972. https://doi.org/10.1016/j.fertnstert.2015.05.011. Wu X, Tao P, Zhou Q, et al. IL-6 secreted by cancer-associated fibroblasts promotes epithelial-mesenchymal transition and metastasis of gastric cancer via JAK2/STAT3 signaling pathway. Oncotarget. 2017;8(13):20741–50. https://doi.org/10.18632/oncotarget.15119. Goulet CR, Champagne A, Bernard G, et al. Cancer-associated fibroblasts induce epithelial–mesenchymal transition of bladder cancer cells through paracrine IL-6 signalling. BMC Cancer. 2019;19(1):137. https://doi.org/10.1186/s12885-019-5353-6. Weng Y-S, Tseng H-Y, Chen Y-A, et al. MCT-1/miR-34a/IL-6/IL-6R signaling axis promotes EMT progression, cancer stemness and M2 macrophage polarization in triple-negative breast cancer. Mol Cancer. 2019;18(1). https://doi.org/10.1186/s12943-019-0988-0. Zhang KW, Wang D, Cai H, et al. IL–6 plays a crucial role in epithelial–mesenchymal transition and pro–metastasis induced by Sorafenib in liver cancer. Oncol Rep. 2021;45(3):1105–17. https://doi.org/10.3892/or.2021.7926. Li L, Gao H, Pan L, et al. All-trans retinoic acid inhibits epithelial-to-mesenchymal transition (EMT) through the down-regulation of IL-6 in endometriosis. Ann Palliat Med. 2021;10(11):11348–61. https://doi.org/10.21037/apm-21-2175. Rothlein R, Dustin ML, Marlin SD, Springer TA. A human intercellular adhesion molecule (ICAM-1) distinct from LFA-1. J Immunol. 1986;15(4):1270–4. Alkhamesi NA, Ziprin P, Pfistermuller K, Peck DH, Darzi AW. Icam-1 mediated peritoneal carcinomatosis, a target for therapeutic intervention. Clin Exp Metastasis. 2005;22:449–59. Ziprin P, Ridgway PF, Pfistermüller KL, Peck DH, Darzi AW. ICAM-1 mediated tumor-mesothelial cell adhesion is modulated by IL-6 and TNF-α: a potential mechanism by which surgical trauma increases peritoneal metastases. Cell Commun Adhes. 2003;10(3):141–54.

Acknowledgements

This work was supported by NIH U54 HD052668 and Endometriosis Foundation of America AWD0003567. Author information Authors and Affiliations Corresponding author Ethics declarations Ethics Approval Ethics approved by Yale University. Consent All authors gave consent to publish the data. Conflict of interest Authors declared that there are no conflicts of interest. Additional information Publisher’s Note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations. Rights and permissions Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. About this article Cite this article Han, E., Mamillapalli, R., Cevik, E.C. et al. IL-6 Inhibits Invasion in a Murine Model of Endometriosis. Reprod. Sci. 32, 3557–3566 (2025). https://doi.org/10.1007/s43032-025-01984-7 Received: Accepted: Published: Version of record: Issue date: DOI: https://doi.org/10.1007/s43032-025-01984-7

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endometriosisinfertility

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Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis Endometriosis

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