Differences in the stem cell-associated gene expression of eutopic endometrium from endometriosis patients in comparison to healthy women

Ruan van Rensburg, V Kreuzer, D Baton-Büst, Ruth Grümmer, Tanja Fehm, Dieter Niederacher, Alexandra P. Bielfeld, Ines Beyer
In: Geburtshilfe und Frauenheilkunde · 2018 · doi:10.1055/s-0038-1671062 · W2899393734
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study compared eutopic endometrium stem cell-associated gene expression between endometriosis patients and healthy women.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-08 · read from full text ⓘ

This study compared gene expression in endometrial biopsies from healthy women (n=19) versus women with endometriosis at ASRM stages I–II (n=19) and III–IV (n=11), focusing on stem cell-associated genes using real-time PCR and immunohistochemistry in endometrial stromal and epithelial cells. The authors found differential upregulation of multiple stem cell markers in eutopic endometrium, including OCT-4 increased in both ASRM I–II and III–IV groups, SOX-2 increasing progressively with significance in stage III–IV, and NANOG and Klf-4 upregulated only in stage III–IV, while c-Myc was not significantly changed. Musashi-1 was significantly upregulated across all endometriosis grades compared with controls. A key limitation stated is that the work is based on eutopic endometrium comparisons and requires further studies to elucidate the mechanisms and interplay of the regulated genes. This paper is centrally about endometriosis — it examines stem cell-associated gene expression differences in eutopic endometrium of endometriosis patients versus healthy controls.

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Abstract

To investigate possible differences in the gene expression of eutopic endometrium of healthy women compared to the eutopic endometrium of endometriosis patients with a special emphasis on stem cell-associated genes.
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Objective

To investigate possible differences in the gene expression of eutopic endometrium of healthy women compared to the eutopic endometrium of endometriosis patients with a special emphasis on stem cell-associated genes.

Materials and methods

Endometrial biopsies consisting of endometrial stromal cells (ESCs) and endometrial epithelial cells (EECs) of patients with and without endometriosis (n = 19 healthy controls, n = 19 endometriosis ASRM I-II°, n = 11 ASRM III-IV°) were investigated via real-time PCR and immunohistochemistry for a panel of stem cell-associated genes.

Results

To further investigate the stem cell nature of endometriosis, stem cell associated genes, especially those required for the reprogramming of differentiated cells, were analysed. NANOG and Klf-4, but not c-Myc, showed significant upregulation only in the Grade III-IV group compared to the healthy group. Oct-4, however, was significantly upregulated in both Grade I-II and Grade III-IV endometriosis groups when compared to the control. SOX-2 showed a steady increase from normal to endometriosis group, which was significant for Grade III-IV. Musashi-1, as a maintainer of stem cell function, is also significantly upregulated in all grades of endometriosis when compared to the control.

Conclusion

Our results indicate a significant upregulation of various stem cell-associated markers, in the eutopic endometrium of endometriosis patients in comparison to healthy women. This supports the stem cell nature of endometriosis and should be further explored. On-going investigations will further elucidate the interplay of the regulated genes.

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endometriosis

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