Increased expression of macrophage colony–stimulating factor and its receptor in patients with endometriosis

Patients with endometriosis have higher levels of colony-stimulating factor 1 (CSF-1) and its receptor, C-FMS.

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Nicole M. Budrys, M.D., M.P.H., Hareesh B. Nair, Ph.D., Ya-Guang Liu, Ph.D., Nameer B. Kirma, Ph.D., Peter A. Binkley, B.S., Shantha Kumar, Ph.D., Robert S. Schenken, M.D., Rajeshwar Rao Tekmal, Ph.D.

Vol 97, Issue 5, Pages 1129-1135.e1



To investigate the expression and regulation of colony-stimulating factor 1 (CSF-1) and its receptor, C-FMS, in endometriosis.


In vivo and vitro study.


University-based academic medical center.


Reproductive-age women undergoing surgery for benign conditions.


Peritoneal and endometrial tissue samples were obtained.

Main Outcome Measure(s):

CSF-1 and C-FMS expression.


Significantly higher CSF-1 levels were found in peritoneal fluid of patients with endometriosis compared with control subjects. Ectopic endometriotic tissue had 3.5-fold and 1.7-fold increases in CSF-1 and C-FMS expression, respectively, compared with eutopic tissue. Coculture of endometrial cells from either established cell lines or patient samples with peritoneal mesothelial cells (PMCs) led to increased expression of CSF-1 and C-FMS. A higher but nonsignificant increase in levels of C-FMS and CSF-1 was found in cocultures of endometrial epithelial cells from patients with endometriosis compared with those without endometriosis.


Increased CSF-1 levels may contribute to endometriosis lesion formation and progression. Elevation in CSF-1 after coculture of endometrial cells with PMCs suggests that endometrial tissue may be a source of peritoneal CSF-1. Increased C-FMS expression in endometrial cells from women with endometriosis cocultured with PMCs suggests that endometrial tissue involved in lesion formation is highly responsive to CSF-1 signaling.

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Fertility and Sterility

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