The Different Gene Expression Profile in the Eutopic and Ectopic Endometrium Sheds New Light on the Endometrial Seed in Endometriosis
This review analyzed gene expression in eutopic and ectopic endometrium to compare endometriosis development to the "seed and soil" hypothesis, finding subtle changes in eutopic endometrium precede significant differences in ectopic tissue.
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This systematic review (PRISMA-S) compared how endometriosis aligns with the “seed and soil” concept by re-analyzing mRNA expression data from eutopic and ectopic endometrium, with a focus on epithelial–mesenchymal transition (EMT) changes. The authors found extremely high mRNA profile similarity between eutopic endometrium from patients without endometriosis and eutopic endometrium from patients with endometriosis (~99.1%), whereas eutopic endometrium from patients with endometriosis showed a lower similarity to ectopic lesions (95.3%). EMT-associated gene analysis showed only minor differences, particularly for claudin family members, without apparent loss of other cell–cell junctions important for the epithelial phenotype, and the authors conclude that early changes in the “seed” are subtle while most differences emerge after implantation into ectopic “soil.” This paper is centrally about endometriosis — it evaluates eutopic versus ectopic endometrial gene expression through the seed-and-soil framework to explain how endometriosis develops.
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