Geburtshilfe Frauenheilkd 2015; 75 - P15
DOI: 10.1055/s-0035-1558381

Progesterone-independent induction of decidualization of endometrial stromal cells of patients with and without endometriosis

J Thomczik 1, I Beyer 2, DM Baston-Büst 2, SJ Böddeker 2, G Wennemuth 1, AP Hess 2, R Grümmer 1
  • 1Universitätsklinikum Essen, Anatomie, Essen, Deutschland
  • 2Universitätsklinikum Düsseldorf, Frauenklinik, UniKiD, Düsseldorf, Deutschland

Study question:

Can decidualization be induced in endometrial stromal cells of endometriosis patients independent from the progesterone receptor pathway?

Methods:

Endometrium of patients with and without endometriosis was obtained from surgical treatments at the University Hospital of Duesseldorf. Endometrial progesterone receptor status was determined by immunohistochemistry and analyzed semi-quantitatively. Endometrial stromal cells (ESCs) were isolated from all endometria by combined enzymatic and mechanical treatment. Stromal cells were cultured in 6-well plates and treated at confluence with progesterone (0.1 – 1µM), MPA (1µM), cAMP (0.5 mM) and forskolin (25µM) alone or with progestins in combination with cAMP or forskolin for 6 days. The induction of decidualization was determined by quantification of secreted prolactin by ELISA (IBL). In parallel, cell number per 6-well was evaluated.

Results:

In ESCs of all patients with and without endometriosis, decidualization was not induced by progestin treatment alone after 6-days, but the prolactin secretion significantly increased by cAMP as well as forskolin treatment. This effect of cAMP/forskolin on decidualization induction was enhanced by a combined treatment with MPA, but not with progesterone in endometrial stromal cells of patients with as well as without endometriosis. In general, cell number significantly decreased after successful induction of decidualization. No correlation of the effect of the different treatments to the intensity of progesterone receptor staining in the eutopic endometrial tissue could be observed.

Conclusion:

The decidualization of ESCs from patients with endometriosis can be successfully induced by activation of the cAMP signaling pathway. This effect can be increased by a combined treatment with MPA. This represents a promising approach for the development of a new therapeutic tool for the treatment of endometriosis.