Epithelial–Mesenchymal Transition in Endometriosis—When Does It Happen?

Lutz Konrad, Raimund Dietze, Muhammad A Riaz, Georgios Scheiner-Bobis, Georgios Scheiner‐Bobis, Judith Behnke, Fabian Horné, Alena Hoerscher, Christoph Reising, Ivo Meinhold‐Heerlein, Ivo Meinhold-Heerlein
Journal of clinical medicine · 2020 · vol. 9(6) , pp. 1915 · doi:10.3390/jcm9061915 · PMID:32570986 · W3035830851
review OA: gold CC0 ⤵ 89 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This review examines EMT pathways in endometriosis, finding that partial EMT, not a prerequisite for cell detachment, occurs primarily in ectopic lesions due to microenvironment interactions.

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Abstract

Epithelial-mesenchymal transition (EMT) is an important process of cell remodeling characterized by the gradual loss of the epithelial phenotype and progressive gain of a mesenchymal phenotype. EMT is not an all-or-nothing process, but instead a transition of epithelial to mesenchymal cells with intermediate cell states. Recently, EMT was described in endometriosis, and many EMT-specific pathways like Twist, Snail, Slug, Zinc finger E-box-binding homeobox 1/2 (ZEB1/2), E/N-cadherin, keratins, and claudins are involved. However, as pointed out in this review, a comparison of the eutopic endometrium of women with and without endometriosis yielded only subtle changes of these EMT markers. Furthermore, only very few alterations in cell-cell contacts could be found but without changes in the epithelial phenotype. This suggests only a partial EMT which is not a prerequisite for the detachment of endometrial cells and, thus, not critical for the first step(s) in the pathogenesis of endometriosis. In contrast, the majority of changes in the EMT-related marker expression were found in the ectopic endometrium, especially in the three endometriotic entities, ovarian, peritoneal, and deep infiltrating endometriosis (DIE), compared with the eutopic endometrium. In this review, we examine the most important EMT pathways described in endometriosis and propose that partial EMT might result from the interaction of endometrial implants with their surrounding microenvironment.

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Condition tags

endometriosisdie_deep_infiltrating

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

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Cited by (50)

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