Endometriose - eine Stammzellerkrankung?

A Starzinski-Powitz, Anna Starzinski‐Powitz, Andreas Zeitvogel, A Zeitvogel, A Schreiner, R Baumann, R Baümann
Zentralblatt fur Gynakologie · 2003 · vol. 125(07/08) , pp. 235–238 · doi:10.1055/s-2003-42276 · PMID:14505255 · W2418290049
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⚙ AI-generated summary by claude@2026-06, 2026-06-07 ⓘ

This paper proposes that less differentiated endometrial cells with stem cell-like features, found in retrogradely menstruated material, may be the cellular source of endometriosis lesions.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-07 ⓘ

The paper discusses a stem-cell/plasticity model of endometriosis, proposing that retrogradely menstruated endometrial cells entering the pelvic cavity represent a mixture of developmental stages that can be distinguished by markers such as cytokeratin and E-cadherin. It argues by analogy to other cell systems that less differentiated cells could both self-renew and generate differentiated daughter cells, thereby sustaining disease and forming new endometriotic lesions. Epithelial cells of different developmental stages are described as being found in both deep infiltrating lesions (e.g., colon) and peritoneal biopsies, supporting the idea that such cells may be the initial and persisting cellular source. The paper is a model-based discussion and does not present direct experimental validation of stem cell behavior itself. This paper is centrally about endometriosis — it specifically proposes endometriosis as a stem cell/plasticity disorder of retrogradely shed endometrial cells.

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Abstract

Endometriosis is an estrogen-dependent and chronic disease with an unknown etiology and pathogenesis. It is however likely and well accepted that retrograde menstruation of endometrial cells into the pelvic cavity is the origin of this disease in many cases. Here we discuss a model in which retrogradely menstruated endometrial cells have different inherent developmental properties because they represent in fact a mixture of different developmental cell stages. These stages can be distinguished in part by the expression of marker proteins such as cytokeratin (intermediate filament protein of epithelial cells) or E-cadherin (intercellular adhesion protein of epithelial cells and metastasis suppressor molecule). Cytokeratin-positive E-cadherin negative cells, for example, would be less differentiated epithelial cells than cytokeratin-positive E-cadherin positive cells. In analogy to findings in other cell systems we assume that the cells which are undifferentiated or not fully differentiated still have the potential to give rise to differentiated daughter cells and, on the other hand, could be maintained as a pool of rather undifferentiated cells and capable of self renewal. This feature would be similar to stem cells (SC) and cells with plasticity. Interestingly we find epithelial cells of different developmental stages in deep infiltrating (e. g. of colon) or peritoneal endometriotic lesions. Therefore we conclude that less differentiated cells in retrogradely menstruated endometrial cell populations possibly representing SC features or plasticity might be the cellular source of primary endometriotic lesions and those present in lesions may contribute to the persistence of the disease by detaching and forming secondary lesions.

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Stem Cells Cell Differentiation Endometriosis Endometriosis Female Humans Menstruation Disturbances Stem Cells

Citation neighborhood

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