• Clinical and Experimental Reproductive Medicine
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• 제25권1호
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• pp.17-24
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• 1998

We have previously demonstrated that specific antigens involved in autoimmunity in endometriosis may be endometrial proteins with molecular weight (mw) of 71, 92, and 103 kilodalton (kDa). The purposes of this study were to determine the incidence of IgG antibodies against these endometrial antigens in peritoneal fluid of patients with endometriosis and to evaluate the antigenic differences between the endometria of patients with and without endometriosis. Forty peritoneal fluid (PF) from 24 patients with endometriosis and 16 patients without endometriosis (control patients) were tested against endometrial protein from patients (n=8) with endometriosis and from control patients (n=10) by western blot. Fifteen (62.5%) of 24 PF samples from patients with endometriosis had specific Immunoglobuiin (Ig) G antibodies against one of three endometrial proteins with mw of 71, 92 and 103 kDa but none of PF samples from control patients had these antibodies. The electrophoretic pattern of endometrial proteins from patients with endometriosis was similiar to that from control patients. Furthemore there was no significant difference in specific PF Immunoglobulin G binding to endometrial proteins regardless of origin of these proteins. Our data indicate that specific humoral immune response can be found in PF of patients with endometriosis and that specific antigens inducing this immune response are present in human endometrium and that there is no antigenic difference between the endometria of patients with and without endometriosis.

• 한국수의병리학회지
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• 제1권2호
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• pp.149-152
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• 1997

A 13-years and 8-months old Jindo dog showed vomiting and pale red vulvular discharge. At necropsy, the uterus was swollen and endometrium was diffusely thickened by numerous protruding cysts which measured approximately from 0.5 to 1 cm in diameter. On sectioning the cysts exuded pale red watery fluid. histologically the endometrium was thickened and characterized by mild to moderate edema congestion and hemorrhagic foci. The cystic endometrial glands were lined by a single layer of flattened cuboidal or vacuolated columnar epithelium. Occasional dilated glands had traversed through the submucosa into the myometrial region. Afew mixed inflammatory cells infiltrated in the lamina propria. Bacteriologically Escherichia coli was isolated from the uterine contents. Gross and microscopic finding were consistent with cystic endometrial hyperplasia.

• Clinical and Experimental Reproductive Medicine
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• 제26권3호
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• pp.331-338
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• 1999

The purposes of this study were to evaluate the effects of insulin-like growth factor (IGF)s in peritoneal fluid (PF) from patients with and without endometriosis on the proliferation of endometrial stromal cells and to investigate the effects of type I IGF receptor antibody on the response of endometrial stromal cells to PF from patients with endometriosis. IGFs in PF from patients with endometriosis (n=14) and without endometriosis (n=10) were measured by immunoradiometric assay and PF samples were divided into low IGF-I PF group (less than 85 ng/ml) and high IGF-I PF group (more than 85 ng/ml). Endometrial stromal cells from patients without endometriosis were cultured in serum free media in the presence or absence of 1 % PF and thymidine incorporation test were used to evaluate the proliferation of endometrial stromal cells. Also cultures were incubated with type I IGF receptor monoclonal antibody (${\alpha}IR_3$) before adding PF. PF from patients with endometriosis and without endometriosis increased thymidine incorporation in endometrial stromal cells. In patients with endometriosis, high IGF-I PF group had high IGF-II levels and resulted in higher thymidine incorporation than low IGF-I PF group but no significant difference in increase in thymidine incorporation between high IGF-I and low IGF-I PF group was noted in patients without endometriosis. There was not a significant correlation between increase in thymidine incorporation and IGF-I levels in PF from patients without endometriosis but in PF from patients with endometriosis. Preincubation with ${\alpha}IR_3$ significantly inhibited the mitogenic response of endometrial stromal cells to PF. Our data indicate that IGF-I in PF may be involved in the growth of ectopic endometrium in patients with endometriosis.

• IMMUNE NETWORK
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• 제23권2호
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• pp.14.1-14.14
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• 2023

Immune status including the immune cells and cytokine profiles has been implicated in the development of endometriosis. In this study, we analyzed Th17 cells and IL-17A in peritoneal fluid (PF) and endometrial tissues of patients with (n=10) and without (n=26) endometriosis. Our study has shown increased Th17 cell population and IL-17A level in PF with endometriosis patients. To determine the roles of IL-17A and Th17 cells in the development of endometriosis, the effect of IL-17A, major cytokine of Th17, on endometrial cells isolated from endometriotic tissues was examined. Recombinant IL-17A promoted survival of endometrial cells accompanied by increased expression of anti-apoptotic genes, including Bcl-2 and MCL1, and the activation of ERK1/2 signaling. In addition, treatment of IL-17A to endometrial cells inhibited NK cell mediated cytotoxicity and induced HLA-G expression on endometrial cells. IL-17A also promoted migration of endometrial cells. Our data suggest that Th17 cells and IL-17A play critical roles in the development of endometriosis by promoting endometrial cell survival and conferring a resistance to NK cell cytotoxicity through the activation of ERK1/2 signaling. Targeting IL-17A has potential as a new strategy for the treatment of endometriosis.

• Clinical and Experimental Reproductive Medicine
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• 제42권3호
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• pp.126-129
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• 2015

Essure (Bayer) received approval from the U.S. Food and Drugs Administration as a permanent non-hormonal contraceptive implant in November 2002. While the use of Essure in the management of hydrosalpinx prior to in vitro fertilization (IVF) remains off-label, it has been used specifically for this purpose since at least 2007. Although most published reports on Essure placement before IVF have been reassuring, clinical experience remains limited, and no randomized studies have demonstrated the safety or efficacy of Essure in this context. In fact, no published guidelines deal with patient selection or counseling regarding the Essure procedure specifically in the context of IVF. Although Essure is an irreversible birth control option, some patients request the surgical removal of the implants for various reasons. While these patients could eventually undergo hysterectomy, at present no standardized technique exists for simple Essure removal with conservation of the uterus. This article emphasizes new aspects of the Essure procedure, as we describe the first known association between the placement of Essure implants and the subsequent development of fluid within the uterine cavity, which resolved after the surgical removal of both devices.

• 한국수정란이식학회지
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• 제12권3호
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• pp.229-246
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• 1997

Implantation is a most important biological process during pregnancy whereby conceptus establishes its survival as well as maintenance of pregnancy. During the periimplantation period, both uterine endometriurn and conceptus synthesize and secrete a host of growth factors and cytokines which mediate the actions of estrogen and /or progesterone and also exert their steroid-independent actions. Growth factors expressed by the materno-conceptal unit en masse have important roles in cell migration, stimulation or inhibition of cell proliferation, cellular differentiation, maintenance of pregnancy and materno-conceptal communications in an autorcrine /paracrine manner. The present review focuses on the role of the intrauterine IGF system during periimplantation conceptus development. The IGF system comprises of IGF- I and IGF- II ligands, types I and II IGF receptors and six or more IGF-binding proteins(IGFBPs). IGFs and IGFBPs are expressed and secreted by uterine endometrium with tissue, pregnancy stage and species specificities under the influence of estrogen, progesterone and other growth factor(s). Conceptus also synthesizes components of the IGF system beginning from a period between 2-cell and blastocyst stages. Maternal IGFs are utilized by both maternal and conceptal tissues; conceptus-derived growth factors are believed to be taken up primarily by conceptus. IGFs enhance the development of both maternal and conceptal compartments in a wide range of biological processes. They stimulate proliferation and differentiation of endometrial cells and placental precursor cells including decidual transformation from stromal cells, placental formation and the synthesis of some steroid and protein hormones by differentiated endometrial cells or placenta. It is also well-documented in a number of experimental settings that both IGFs stimulate preimplantation embryo development. In slight contrast to these, prenatal mice carrying a null mutation of IGF and /or IGF receptor gene do not exhibit any apparent growth retardation until after implantation. Reason (s) for this discrepancy between the knock-out result and the in vitro ones, however, is not known. IGFBPs, in general, are believed to inhibit IGF action within the materno-conceptal unit, thereby allowing endometrial stromal cell differentiation as well as dampening ex cessive placental invasion into maternal tissue. There is evidence, however, indicating that IGFBP can enhance IGF action depending on environrnental conditions perhaps by directioning IGF ligand to the target cell. There is also a third possibility that certain IGFBPs and their proteolytic fragments may have their own biological activities independent of the IGF. In addition to IGFBPs, IGFBP proteases including those found within the uterine tissue or lumen are thought to enhance IGF bioavailability by degrading their substrates without affecting their bound ligand. In this regard, preliminary results in early pregnant pigs suggest that a partially characterized IGFBP protease activity in uterine luminal fluid enhances intrauterine IGF bioavailability during conceptus morphological development. In summary, a number of in vitro results indicate that IGFs stimulates the development of the rnaterno-conceptal unit during the periimplantation period. IGFBPs appear to inhibit IGF action by sequestering their ligands, whereas IGFBP proteases are thought to enhance intrauterine bioavailability of IGFs. Much is remaining to be clarified, however, regarding the roles of the individual IGF system components. These include in vivo evidence for the role of IGFs in early conceptus development, identification of IGF-regulated genes and their functions, specific roles for individual IGFBPs, identification and characterization of IGFBP proteases. The intrauterine IGF club house thus will be paying a lot of attention to forthcoming results in above and other areas, with its door wide-open!

• 한국발생생물학회지:발생과생식
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• 제13권1호
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• pp.1-11
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• 2009

착상은 배아측과 모체측의 내분비적, 측분비적 및 자가분비적 인자들의 상호 작용에 의하여 조절된다. 착상의 적기는 $2{\sim}4$일로서 이 특수한 시간대 안에서 signaling, appositioning, attachment 및 invasion을 통하여 순차적으로 배아의 착상이 이루어지는데, 이는 자궁내막과 배아로부터 여러 사이토카인, 성장인자, 부착인자와 같은 다수의 생화학 인자의 생성과 분비를 포함하며 이로 인하여 수용적인 자궁내막이 형성된다. LIF, CSF-1, IL-1과 같은 사이토카인들은 착상을 이끄는 연속적인 사건에서 중요한 역할을 수행하며 integrin, L-selectin ligands, glycodelin, mucin-1, HB-EGF, pinopodes는 appositioning과 attachment에 관여한다. 배아 또한 사이토카인과 성장인자 및 LIF, CSF-1, IGF, HB-EGF에 대한 수용체들을 분비하여 능동적으로 대처한다. 자궁내막의 수용성을 평가하고 자연주기 또는 보조생식술을 이용한 임신의 예후를 예측하는데, 이와 같은 인자들이 유용한지는 앞으로 더 연구되어야 한다. 현재로서는 내막조직으로부터 채취한 integrins, pinopodes, glycodelin, LIF가, 자궁강내 세척액에서는 glycodelin과 LIF가 유망한 인자로 떠오르고 있다. 혈액내 마커로서는 VEGF, glycodelin, CSF가 약간의 연관성을 보여주고 있다. 이러한 인자들이 보조생식술 전후로 자궁내막의 기능과 임신의 예후를 평가하는 선별검사로 이용될 수 있는지를 증명하기 위해서는 향후 불임 여성과 대조군인 가임 여성을 대상으로 한 대규모의 연구가 필요할 것이다. 인간의 착상에서 이들 인자들의 기능을 충분히 이해해야 치료적 기법으로 연결되어 보조생식술에서도 더 높은 성공률을 이루어 낼 것으로 사료된다.

• Journal of Yeungnam Medical Science
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• 제30권2호
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• pp.145-148
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• 2013

Thoracic endometriosis is an uncommon disease that has four main forms: catamenial pneumothorax, hemothorax, hemoptysis, and pulmonary nodules. Since the growth of endometrial tissue depends on the presence of estrogen, thoracic endometriosis usually occurs in menstruating women between 25 and 35 years of age. Menstrual disturbances are common in women with chronic kidney disease (CKD). However, they could be reversed after kidney transplantation. Therefore, previously asymptomatic endometriosis may become symptomatic after kidney transplantation. A 49-year-old woman with CKD underwent kidney transplantation. A month later, she experienced dyspnea, and hemothorax in her right hemithorax. However, there was no evidence of infectious diseases and malignancy in thoracentesis, pleural biopsy, and computed chest tomography (CT). The serum and pleural fluid levels of his carbohydrate antigen 125 were elevated. Hemothorax secondary to pleural endometriosis was suspected. We tried hormonal therapy, and the hemothorax disappeared. At the sixth-month follow-up, there was no recurrence of hemothorax.