Endometriosis Located Proximal to or Remote From the Uterus Differentially Affects Uterine Gene Expression
This study found that endometriosis located proximally to the uterus reduced uterine gene expression more severely than distally located lesions, suggesting endometriosis has systemic effects that vary with proximity.
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The study investigated whether endometriosis alters eutopic uterine gene expression through proximity to lesions or via a systemic, distance-independent mechanism. Using a controlled murine model, endometriosis was induced either in the peritoneal cavity (proximal) or at a remote subcutaneous site (distal), and expression of genes involved in endometrial receptivity (Hoxa10, Hoxa11, Igfbp1, Klf9, and progesterone receptor) was measured in eutopic endometrium. Peritoneal (proximal) endometriosis decreased Hoxa10, Igfbp1, Klf9, and total Pgr, whereas distal lesions produced a less severe overall effect but still similarly reduced Igfbp1 and more pronounced effects on Pgr. The paper concludes that endometriosis can exert non-local systemic effects that differentially vary with distance to the uterus and selectively alter receptivity-related genes; its limitation is that it relies on an induced mouse model and selected gene readouts rather than comprehensive uterine profiling. This paper is centrally about endometriosis — it demonstrates that lesion proximity is not required for major, distance-dependent changes in eutopic uterine gene expression.
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