Inflammatory Status Influences Aromatase and Steroid Receptor Expression in Endometriosis

Orhan Bukulmez, Orhan Bükülmez, Daniel B Hardy, Bruce R Carr, R Ann Word, Carole R Mendelson
Endocrinology · 2007 · vol. 149(3) , pp. 1190–1204 · doi:10.1210/en.2007-0665 · PMID:18048499 · PMC2275353 · W2052591056
article OA: bronze CC0 ⤵ 135 in-corpus citations
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study found increased aromatase and COX-2 expression in endometriosis tissues, with a higher ERbeta/ERalpha ratio and PR-C expression in endometriomas, suggesting distinct inflammatory and steroid receptor roles in disease progression.

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Abstract

Aberrant up-regulation of aromatase in eutopic endometrium and implants from women with endometriosis has been reported. Aromatase induction may be mediated by increased cyclooxygenase-2 (COX-2). Recently, we demonstrated that progesterone receptor (PR)-A and PR-B serve an antiinflammatory role in the uterus by antagonizing nuclear factor kappaB activation and COX-2 expression. PR-C, which antagonizes PR-B, is up-regulated by inflammation. Although estrogen receptor alpha (ERalpha) is implicated in endometriosis, an antiinflammatory role of ERbeta has been suggested. We examined stage-specific expression of aromatase, COX-2, ER, and PR isoform expression in eutopic endometrium, implants, peritoneum, and endometrioma samples from endometriosis patients. Endometrial and peritoneal biopsies were obtained from unaffected women and those with fibroids. Aromatase expression in eutopic endometrium from endometriosis patients was significantly increased compared with controls. Aromatase expression in endometriosis implants was markedly increased compared with eutopic endometrium. Aromatase mRNA levels were increased significantly in red implants relative to black implants and endometrioma cyst capsule. Moreover, COX-2 expression was increased in implants and in eutopic endometrium of women with endometriosis as compared with control endometrium. As observed for aromatase mRNA, the highest levels of COX-2 mRNA were found in red implants. The ratio of ERbeta/ERalpha mRNA was significantly elevated in endometriomas compared with endometriosis implants and eutopic endometrium. Expression of PR-C mRNA relative to PR-A and PR-B mRNA was significantly increased in endometriomas compared with eutopic and control endometrium. PR-A protein was barely detectable in endometriomas. Thus, whereas PR-C may enhance disease progression, up-regulation of ERbeta may play an antiinflammatory and opposing role.

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Condition tags

endometriosisendometrioma

MeSH descriptors

Aromatase Endometriosis Endometrium Inflammation Receptors, Estrogen Receptors, Progesterone Adult Aromatase Case-Control Studies Cross-Sectional Studies Cyclooxygenase 2 Cyclooxygenase 2 Endometriosis Endometriosis Endometrium Endometrium Estrogen Receptor alpha Estrogen Receptor alpha Estrogen Receptor beta Estrogen Receptor beta

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.

References (100)

Cited by (50)

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