[HOXA11 gene expression in women with and without impaired infertility].

Ginekologia polska · 2010 · vol. 81(6) , pp. 414–21 · PMID:20695189 · W2427451576
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This study found altered HOXA11 gene expression in the endometrium of women with endometriosis and idiopathic infertility compared to fertile women, suggesting a role in implantation defects.

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This study measured HOXA11 mRNA expression in endometrial tissue across menstrual cycle phases in women with endometriosis (n=36), idiopathic infertility (n=48), and fertile controls (n=30), using real-time quantitative PCR, and assessed HOXA11 protein localization by immunohistochemistry. HOXA11 transcripts were significantly elevated in the midsecretory phase in both the idiopathic infertility and fertile groups, while women with endometriosis showed low HOXA11 transcript levels during the implantation window; fertile controls also differed from endometriosis by showing lower levels in the proliferative phase and higher levels in the midsecretory phase. HOXA11 protein was localized to the nuclei of endometrial stromal cells, with no cytoplasmic staining. The paper concludes that altered HOXA11 expression may be common in endometriosis-related infertility, while acknowledging the need for further mechanistic research. This paper is centrally about endometriosis — it compares HOXA11 expression patterns in the endometrium of women with endometriosis versus idiopathic infertility and fertile controls.

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Abstract

INTRODUCTION: HOXA genes are receptivity markers and their altered expression can help identify women with implantation defect. OBJECTIVES: The purpose of this study was to examine the expression pattern of HOXA11 and expression and localization of its protein product in the endometrium of women with endometriosis, idiopathic infertility and normal fertile patients during different phases of the menstrual cycle. MATERIAL AND METHODS: We evaluated HOXA11 mRNA level in the endometrium from endometriosis (n=36), idiopathic infertility (n=48) and fertile patients (n=30) during a menstrual cycle. The amounts of mRNA were determined by real-time quantitative PCR. Using the immunohistochemical techniques we compared the localization of HOXA11 protein in the proliferative, early secretory and midsecretory endometrium in all of the studied groups. Endometrial biopsy was performed by pipelle or during hysteroscopy. RESULTS: We observed statistically significantly elevated HOXA11 transcripts levels in the midsecretory phase in both, the idiopathic infertility and the fertile control groups (p<0.05). Patients with endometriosis had low HOXA11 transcript level in the implantation window. Normal fertile patients showed statistically significantly decreased (p=0.003) HOXA11 mRNA level in the proliferative phase and statistically significantly increased level (p=0.018) in midsecretory phase, comparing to endometriosis patients. HOXA11 protein were localized in the nuclei of the endometrial stromal cells whereas the cytoplasm of these cells did not stain. CONCLUSION: Our results suggest that altered HOXA11 gene expression in the endometrium during a menstrual cycle may be a common phenomenon among patients with endometriosis and may cause infertility in this group of patients. Further research should explain the mechanism of altered expression of HOXA11 gene.
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Abstract

Summary Introduction: HOXA genes are receptivity markers and their altered expression can help identify women with implantation defect. Objectives: The purpose of this study was to examine the expression pattern of HOXA11 and expression and localization of its protein product in the endometrium of women with endometriosis, idiopathic infertility and normal fertile patients during different phases of the menstrual cycle. Material and methods: We evaluated HOXA11 mRNA level in the endometrium from endometriosis (n=36), idiopathic infertility (n=48) and fertile patients (n=30) during a menstrual cycle. The amounts of mRNA were determined by real-time quantitative PCR. Using the immunohistochemical techniques we compared the localization of HOXA11 protein in the proliferative, early secretory and midsecretory endometrium in all of the studied groups. Endometrial biopsy was performed by pipelle or during hysteroscopy. Results: We observed statistically significantly elevated HOXA11 transcripts levels in the midsecretory phase in both, the idiopathic infertility and the fertile control groups (p<0.05). Patients with endometriosis had low HOXA11 transcript level in the implantation window. Normal fertile patients showed statistically significantly decreased (p=0.003) HOXA11 mRNA level in the proliferative phase and statistically significantly increased level (p=0.018) in midsecretory phase, comparing to endometriosis patients. HOXA11 protein were localized in the nuclei of the endometrial stromal cells whereas the cytoplasm of these cells did not stain. Conclusion: Our results suggest that altered HOXA11 gene expression in the endometrium during a menstrual cycle may be a common phenomenon among patients with endometriosis and may cause infertility in this group of patients. Further research should explain the mechanism of altered expression of HOXA11 gene.

Keywords

endometriosisinfertility

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Condition tags

endometriosisinfertility

MeSH descriptors

Gene Expression Homeodomain Proteins Infertility, Female Menstrual Cycle Case-Control Studies Endometrium Endometrium Female Homeodomain Proteins Humans Infertility, Female Menstrual Cycle Poland Reverse Transcriptase Polymerase Chain Reaction RNA, Messenger RNA, Messenger RNA, Messenger

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