Endometrial Mesenchymal Stem Cells and Their Role in the Origin and Treatment of Endometriosis

Jitong Zhao, Xiaojuan Lin, Tao Yi, An Tong, Ruyu Pi, Gang Zheng, Shuying Liao, Xia Zhao, Ce Bian, Guojuan Sun
In: Clinical and Experimental Obstetrics & Gynecology · 2022 · vol. 49(12) · doi:10.31083/j.ceog4912263 · W4311101780
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⚙ AI-generated summary by claude@2026-06, 2026-06-09 ⓘ

Endometrial mesenchymal stem cells were identified in retrograde menstruation and endometriosis lesions but not normal tissue, suggesting a role in disease development and recurrence, with GnRH-a showing no effect on these cells.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This study investigated whether endometrial mesenchymal stem cells (eMSCs) marked by PDGFR- and CD146 are present in retrograde menstruation and in different endometriosis-related lesions, by analyzing tissues from 508 surgically treated women with ovarian endometriosis, adenomyosis, abdominal wall scar endometriosis, or deep endometriosis and comparing them with normal tissue types; eMSCs were detected in retrograde menstruation and endometriotic lesions but not in normal ovary, myometrium, adipose tissue, or peritoneal membrane. The authors also compared eMSC percentages in patients receiving postoperative GnRH-a (6 cycles; with a subset treated preoperatively for at least 3 cycles) versus matched controls in adenomyosis and deep endometriosis, finding no statistical differences in eMSC proportions. A major caveat is that eMSCs were assessed using immunofluorescence marker detection and percent estimates, with only 23 retrograde menstruation cases available for analysis. This paper is centrally about endometriosis — it identifies eMSCs in retrograde menstruation and endometriotic lesions and tests whether GnRH-a changes eMSC levels as a potential contributor to persistence or recurrence.

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Abstract

Background: To identify endometrial mesenchymal stem cells (eMSCs) in retrograde menstruation, in various endometriosis lesions, in normal control tissues, and to investigate the association between eMSCs and endometriosis. We also plan to evaluate the effect of gonadotropin-releasing hormone agonists (GnRH-a) on eMSCs. Methods: Patients diagnosed with endometriosis were included if they had experienced surgery during the time frame 1 January 2015 to 31 December 2019 in West China Second Hospital, Sichuan University. Immunofluorescence was performed to identify eMSCs in those tissues with cell surface markers PDGFR-β/CD146. The percents of eMSCs in various tissues were calculated, and compared using analysis of variance. A two-sided pvalue less than 0.05 showed significant difference. Results: This study included 508 patients. eMSCs were identified in retrograde menstruation and numerous pathologic specimen but were not detected in normal control tissues. There was no significant difference in the percent of eMSCs between the GnRH-a treatment group and the control group (p > 0.05). Conclusions: Our study demonstrated that eMSCs played a critical role in the development and recurrence of endometriosis and that GnRH-a did not affect eMSCs. Gynecologists should regard endometriosis as a chronic disease requiring lifetime management, especially for patients with chronic pelvic pain.

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Condition tags

endometriosischronic_pelvic_pain

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