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Oestrogen, progesterone and stem cells: the discordant trio in endometriosis?

Published online by Cambridge University Press:  08 March 2018

Chithra Janardhanan Susheelamma ,
Sathy M. Pillai  and
Sivakumari Asha Nair
Chithra Janardhanan Susheelamma
Affiliation:
Cancer Research Program-4, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram 695014, Kerala, India
Sathy M. Pillai
Affiliation:
Samad IVF Hospital, Thiruvananthapuram 695035, Kerala, India
Sivakumari Asha Nair*
Affiliation:
Cancer Research Program-4, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram 695014, Kerala, India
*
Author for Correspondence: Sivakumari Asha Nair, Cancer research program-4, Rajiv Gandhi Centre for Biotechnology, Thiruvananthapuram 695014, Kerala, India. Tel: 0471-2529501; E-mail: sasha@rgcb.res.in
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Abstract

Oestrogen–progesterone signalling is highly versatile and critical for the maintenance of healthy endometrium in humans. The genomic and nongenomic signalling cascades initiated by these hormones in differentiated cells of endometrium have been the primary focus of research since 1920s. However, last decade of research has shown a significant role of stem cells in the maintenance of a healthy endometrium and the modulatory effects of hormones on these cells. Endometriosis, the growth of endometrium outside the uterus, is very common in infertile patients and the elusiveness in understanding of disease pathology causes hindrance in selection of treatment approaches to enhance fertility. In endometriosis, the stem cells are dysfunctional as it can confer progesterone resistance to their progenies resulting in disharmony of hormonal orchestration of endometrial homeostasis. The bidirectional communication between stem cell signalling pathways and oestrogen–progesterone signalling is found to be disrupted in endometriosis though it is not clear which precedes the other. In this paper, we review the intricate connection between hormones, stem cells and the cross-talks in their signalling cascades in normal endometrium and discuss how this is deregulated in endometriosis. Re-examination of the oestrogen–progesterone dependency of endometrium with a focus on stem cells is imperative to delineate infertility associated with endometriosis and thereby aid in designing better treatment modalities.

Keywords

Endometrial stem cellsoestrogenprogesteroneWntNotchHedgehog
Type
Review
Information
Expert Reviews in Molecular Medicine , Volume 20 , 2018 , e2
Copyright
Copyright © Cambridge University Press 2018 

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