Discussion
The present studies are the first to demonstrate expression of mRNA for the histone demethylases KDM4A and KDM4B in granulosa cells. Compared to patients who become pregnant following ART, expression of both histone demethylases was higher in the patients who did not become pregnant, indicating that these epigenetic regulators may play a role in directing proper granulosal function around the time of ovulation and luteal formation.
Ongoing studies are exploring demethylase activity and specific genes affected by KDM4A and KDM4B in cumulus and mural granulosa to correlate mRNA expression with biological function. However, the current findings provide some evidence to suggest differential expression of histone demethylases may impact epigenetic changes and gene expression in granulosa associated with pregnancy.
As an initial approach to examine the potential significance of histone demethylase expression in granulosa cell function, patients were categorized based on pregnancy outcome and expression of KDM4A and KDM4B mRNA in each group was compared. The general demographics of the patients segregating into the pregnant-live birth and not pregnant groups was similar to many previous reports. As anticipated, women that became pregnant following embryo transfer were younger and exhibited higher levels of AMH compared to women that did not become pregnant [50–52]. Age and AMH data extended to anticipated outcomes of less FSH administered, higher peak estradiol, more oocytes retrieved, and greater numbers of 2PN embryos in the pregnant-live birth group [53–55]. It is interesting to note there was no segregation of BMI in the two groups. Several studies have indicated increased BMI inversely correlates with pregnancy outcome [56, 57]. Mean BMI for patients in the pregnant-live birth group was 25.59 (range 19.15–44.8) and was not different from the not pregnant group, 26.85 (range 17.14–40.59); however, both groups were within the overweight category as defined by the World Health Organization (WHO. Obesity and overweight. Fact sheet; Updated June 2016 http://www.who.int/mediacentre/factsheets/fs311/en/). The diagnosed cause of infertility for the current study group is indicated in Table 1. Due to the relatively small sample size of this study, the significance of KDM4A or KDM4B expression as an indicator of infertility within a specific etiology cannot be assessed. However, it will be of future interest to determine, for example, if ovulatory dysfunction is associated with altered expression of KDM4A and or KDM4B.
The ovulatory surge of LH initiates significant change in the expression patterns of many genes within the ovary leading to ovulation and establishment of the corpus luteum. The importance of many of these genes has been further demonstrated by knock-out and knock-down studies in rodents [18, 33, 58–65] and through the identification of mutations associated with infertility in women [66–72]. Recent studies have now begun to tie the expression of several of these critical genes to methylation state providing greater insight to the mechanisms controlling the final maturation of the follicle and ovulation. Increased expression of CYP11A1 in rat granulosa following an ovulatory dose of hCG was associated with increased H3K4me3 and decreased H3K9me3 and H3K23me3 [73]. Similarly, H3K9me3 marks in the StAR promoter were decreased after hCG [74]. These data indicate rapid changes in histone methylation following the ovulatory surge occurring with rapid changes in gene expression. Additional studies highlight altered patterns in methylation of critical genes found in pathological conditions associated with altered fertility. Cumulus granulosa from women with endometriosis have lower CYP19 gene expression compared to cumulus from women without endometriosis. Hypermethylation of H3K9 in the CYP19 promoter was associated with the lower expression [75]. CYP19 expression is also reduced in women with PCOS [76–78]. Studies have demonstrated differences of methylation state in PCOS ovarian tissue compared to controls where some genes were hypermethylated (such as IGFBP2, CYP19A1, AMHR2) and others hypomethylated (INSR, AMH) in PCOS ovaries [79]. Ovarian function and fertility can be impacted by exposure to chemicals in the environment and these effects have also been linked to altered DNA methylation of key genes. Exposure to methoxychlor (MXC), a synthetic insecticide, during critical phases of ovary development during the late prenatal and early postnatal period results in altered ovarian function and reduced fertility in adult mice [80, 81]. Recent studies indicate altered DNA methylation as a mechanism leading to MCX effects. Following MCX dosing up to postnatal day 7, hypermethylation of many genes involved in normal folliculogenesis was found. In addition, altered methylation was observed at postnatal day 60, long after the final dose of MXC [82]. Therefore, patterns of DNA and histone methylation in genes critical for follicular development, ovulation, and luteal formation change as part of normal biology. Methylation patterns different from that observed in normal ovarian tissues have been associated with conditions such as PCOS and altered patterns of methylation in the ovary occur following exposure to environmental reproductive toxins. The current data suggest that the histone demethylase KDM4A and KDM4B may play a role in mediating some of these events. Future studies focused on demonstrating KDM4A and KDM4B demethylase activity on specific target genes in ovarian cell types will substantiate this finding.
Although specific roles for KDM4A and KDM4B in granulosa cell function are yet to be determined, an importance may be inferred from the expression data observed in this study. The correlation in expression level of the histone demethylase KDM4A and KDM4B mRNA was very strong in both cumulus and mural granulosa cells in the not pregnant group. It is interesting to note the correlation in expression was weaker in cells from patients in the pregnant-live birth group. This observation indicates a differential expression of these histone demethylases occurring in cells associated with successful pregnancy compared to cells associated with no pregnancy. Additional analysis was carried out to determine if other characteristics differentiating the pregnant and not pregnant group correlated to KDM4 gene expression. For example, age was significantly lower in the pregnant-live birth group, and therefore, it is possible that KMD4 mRNA expression may correlate with age. However, no strong correlation was observed in KDM4 gene expression and age (Fig. 4) or other parameters assessed including BMI, AMH, peak estradiol, FSH administered, number of oocyte retrieved, or number of 2PN embryos (Supplementary Figures 1–6). Together, these data suggest changes in the expression of KDM4A and KDM4B are not related to factors such as age but may be related to specific cellular functions associated with successful pregnancy.
Currently, it is unclear if the elevated expression in non-pregnant patients represents aberrant induction of KDM4A and KDM4B relative to the pregnant cohort or if there is a failure to repress KDM4A and KDM4B expression at the time of ovulation. It may be that elevated expression of KDM4 in granulosa of the not pregnant group is representative of premature luteinization; KDM4A and KDM4B immunoreactivity was observed in luteal cells (Fig. 3). However, expression of StAR or PGR mRNA, two marker genes of luteinization, did not correlate with KDM4 expression in the current data set (see Supplementary Figures 7 and 8). Further, it is possible a subgroup may exist within either the non-pregnant or pregnant patient groups providing weight to the data due to unidentified pathological conditions. In addition, expression determined here may be related to infertility in general and may not reflect the expression patterns in cells from fertile women. Continued analysis of larger patient cohorts will provide insight toward these possibilities.
Immunostaining confirmed the cellular localization of KDM4A and KDM4B in specific cells within the normal human ovary. This observation is in general agreement with two other reports identifying KDM4 expression in the ovary. First, a meta-analysis of next-generation sequencing conducted on normal human tissues using RNA-Seq Atlas and GENT databases indicated KDM4A, KDM4B, and KDM4C are broadly expressed across several tissue types with high expression in the human ovary [11]. That study further described that based on reads per kilobase per million (RPKM), the expression level of KDM4A and KDM4C was higher than KDM4B in the ovary [11]. In another recent study, generation of KDM4A null mice lead to the identification of a role for KDM4A in preimplantation embryo development and in the maintenance of a uterine environment advantageous to implantation and embryo development [37]. That study further explored general expression levels in the mouse ovary where b-galactosidase staining from KMD4A, B, or C-promotor driven LacZ was illustrated from the authors data (KDM4A) and data from the International Mouse Phenotyping Consortium (KDM4B and KDM4C). In that case, both KDM4A and B expression were noted in the female reproductive tract, with greater overall KDM4A expression described and little to no expression of KDM4C observed [37]. Additionally, KDM4A was detected in the granulosa and oocytes of early stage follicles [37]. In the present study, KDM4A immunostaining was overall weak and appeared diffuse throughout the ovary. However, specific localization was observed in the oocytes, granulosa of growing follicles, and luteal cells. Expression of KDM4B was more robust and was specifically observed in oocytes, granulosa, and theca cells. Differences in the intensity of immunostaining between KDM4A and KDM4B may be a reflection of different levels of protein expression in the human ovary or may reflect variation in the affinity of the antibodies used. Thus, the present data, although not quantitative, demonstrate KDM4A and KDM4B proteins are localized to specific cells within the human follicle and corpus luteum. Considering the newly described role of KDM4A as a maternal effect gene that contributes to the oocyte-embryo transition in the mouse [37], it is also of significant interest that the supporting granulosa cells in humans express both KDM4A and KDM4B.
The present study demonstrates the histone demethylase KMD4A and KDM4B are localized within the ovary to oocytes, granulosa cells, theca, and luteal cells. Differential expression of KDM4A/B mRNA was found with pregnancy in cumulus and mural granulosa cells. These data indicate KDM4A and KDM4B may have a role in control of gene expression important for function and differentiation of granulosa cells supportive of successful pregnancy.
Electronic supplementary material
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Conflict of interest
The authors declare that they have no conflict of interest.
Footnotes
Electronic supplementary material
The online version of this article (10.1007/s10815-018-1151-3) contains supplementary material, which is available to authorized users.
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