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Fertil Steril. 2013 May;99(6):1705-13. doi: 10.1016/j.fertnstert.2013.01.133. Epub 2013 Feb 22.

Possible involvement of signal transducer and activator of transcription-3 in cell-cell interactions of peritoneal macrophages and endometrial stromal cells in human endometriosis.

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1
Department of Obstetrics and Gynecology, Graduate School of Medical Sciences, Kumamoto University, Kumamoto, Japan.

Abstract

OBJECTIVE:

To investigate interactions between peritoneal macrophages and endometrial stromal cells (ESCs) involved in the development of endometriosis.

DESIGN:

Clinicopathologic and in vitro studies.

SETTING:

Department of Obstetrics and Gynecology and Department of Pathology, Kumamoto University Hospital.

PATIENT(S):

Women undergoing laparoscopy or laparotomy to treat endometriosis or other benign gynecologic conditions.

INTERVENTION(S):

We collected samples of peritoneal fluid (ascites), endometrium, and endometriotic tissues. We cocultured ESCs in vitro with or without human macrophages.

MAIN OUTCOME MEASURE(S):

Macrophage phenotypes in peritoneal fluid were determined via immunostaining. Proliferation of ESCs and activation of signal transducer and activator of transcription-3 (Stat3) in cocultures were evaluated.

RESULT(S):

The endometriosis group had a significantly higher total number of macrophages in ascites compared with the control group, but the ratios of CD163+ alternatively activated macrophages (M2) in the two groups did not differ significantly. Coculture with M2 macrophages significantly up-regulated ESC proliferation and Stat3 activation in ESCs in vitro. Proliferation of ESCs was suppressed after Stat3 was down-regulated by small interfering RNA. Stat3 was activated in epithelial cells and ESCs in human endometriotic lesions.

CONCLUSION(S):

Interactions between M2 macrophages and ESCs via Stat3 activation may play an important role in the development of endometriosis.

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