Increased proteolysis in endometriotic tissue and endometrium in women who develop endometriosis may facilitate invasion

摘要

The pathogenesis of endometiiosls is presumed to be related to adhesion and invasion in ectopic sites of dispersed shed endometrium. The mechanism is poorly understood The aim of this project was to investigate the role of the plasminogen-activating system (PAs), including urokinase plasminogen activator (uPA), urokinase plasminogen activator receptor (uPAR), and plasminogen activator inhibitor-1 (PAI-1), in the pathogenesis of endometriosis The system is involved in tissue degradation and remodelling under both normal and pathological conditions This project included the assay of the three proteins in tissue homogenates, localisation of both the proteins and their mRNA in tissue sections, and studies of their release in cell cultures Our major findings were an up-regulation of mRNA for all three factors and higher concentrations of uPA, and PAI-1 in endometriotic and endometrial tissue from women with endometriosis compared to control endometiium,. These findings might be of importance for menstrual shedding, adhesion, and invasion of viable endometrial fragments. The studies have shown above all that there is an important difference in the expression of the components of the PAs in endometrium from women with endometriosis compared to healthy endometrium, supporting the hypothesis that ectopic endometrial invasion takes place, at least partly, as a consequence of a disturbed fibrinolytic activity in the eutopic endometrium.