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Differentiation. 2017 Nov - Dec;98:35-54. doi: 10.1016/j.diff.2017.10.001. Epub 2017 Oct 4.

Response of xenografts of developing human female reproductive tracts to the synthetic estrogen, diethylstilbestrol.

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Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA 94143, United States. Electronic address:
Department of Cancer Biology and Genetics, College of Medicine, Comprehensive Cancer Center, 812 Biomedical Research Tower, 460 West 12th Avenue, Columbus, OH 43210, United States.
Department of Urology, University of California, 400 Parnassus Avenue, San Francisco, CA 94143, United States.
Departments of Pathology and Obstetrics and Gynecology, Duke University Medical Center, Durham, NC 27710, United States.


Human female fetal reproductive tracts 9.5-22 weeks of gestation were grown for 1 month in ovariectomized athymic adult female mouse hosts that were either untreated or treated continuously with diethylstilbestrol (DES) via subcutaneous pellet. Normal morphogenesis and normal patterns of differentiation marker expression (KRT6, KRT7, KRT8, KRT10, KRT14, KRT19, ESR1, PGR, TP63, RUNX1, ISL1, HOXA11 and α-ACT2) were observed in xenografts grown in untreated hosts and mimicked observations of previously reported (Cunha et al., 2017) non-grafted specimens of comparable age. DES elicited several notable morphological affects: (a) induction of endometrial/cervical glands, (b) increased plication (folding) of tubal epithelium, (c) stratified squamous maturation of vaginal epithelium and (d) vaginal adenosis. DES also induced ESR1 in epithelia of the uterine corpus, cervix and globally induced PGR in most cells of the developing human female reproductive tract. Keratin expression (KRT6, KRT7, KRT8, KRT14 and KRT19) was minimally affected by DES. Simple columnar adenotic epithelium was devoid of TP63 and RUNX1, while DES-induced mature vaginal epithelium was positive for both transcription factors. Another striking effect of DES was observed in grafts of human uterine tube, in which DES perturbed smooth muscle patterning. These results define for the first time IHC protein markers of DES action on the developing human reproductive tract, which provide bio-endpoints of estrogen-induced teratogenesis in the developing human female reproductive tract for future testing of estrogenic endocrine disruptors.


Diethylstilbestrol; Epithelium; Estrogenic response; Human female fetal reproductive tract; Mesenchyme; Tissue interactions

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