Eutopic and ectopic stromal cells from patients with endometriosis exhibit differential invasive, adhesive, and proliferative behavior

Ectopic endometrial stromal cells from patients with endometriosis have similar immunophenotype but exhibit altered proliferation, invasion, adhesion, and cytokine production compared with their eutopic counterparts, suggesting the involvement of epigenome in their behavior.

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Ali Akbar Delbandi, M.Sc., Mahmoud Mahmoudi, Ph.D., Adel Shervin, M.D., Elham Akbari, M.D., Mahmood Jeddi-Tehrani, Ph.D., Mojtaba Sankian, Ph.D., Somayeh Kazemnejad, Ph.D., Amir-Hassan Zarnani, Ph.D.

Volume 100, Issue 3, Pages 761-769, September 2013



To study immunophenotype, differential proliferation capacity, invasiveness, adhesion, and cytokine production in ectopic and eutopic endometrial stromal cells (EESCs and EuESCs) from patients with endometriosis.


In vitro study.


Academic research center.


Patients with ovarian endometriosis (endometrioma) and nonendometriotic controls.



Main Outcome Measure(s):

EESCs and EuESCs from 25 patients with endometrioma and ESCs from 20 nonendometriotic controls (CESCs) were isolated, and their immunophenotype, proliferation, invasion, adhesion, and cytokine production were assessed and compared.


Isolated ESCs from all three sources expressed markers specific for cells of mesenchymal origin but were negative for hematopoietic markers. EESCs exhibited a significantly lower proliferation rate in fibronectin-coated plates and less invasive capacity compared with CESCs or EuESCs. Among all stromal cell groups studied, EuESCs showed the highest invasive behavior. EESCs adhered more firmly to extracellular matrix than EuESCs or CESCs in all time intervals examined. The levels of interleukin (IL) -6 and IL-8 production by EESCs were significantly higher compared with those of EuESCs or CESCs.


The results of the present study demonstrated that retrograde menstruation alone does not account for the pathogenesis of endometriosis as eutopic and ectopic counterparts of ESCs from patients with endometriosis exhibit differential invasive, adhesive, and proliferative behavior.

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