Expression of Aromatase and Estrogen Sulfotransferase in Eutopic and Ectopic Endometrium: Evidence for Unbalanced Estradiol Production in Endometriosis
Abstract
Endometriosis is an estrogen-dependent gynecological disease causing pelvic pain and infertility. Impaired estrogen metabolism is thought to play a pivotal role in the pathogenesis of the disease. While there is some information on factors involved in the synthesis of E2, information on E2-deactivating enzymes is still very limited. To elucidate the intracrinology of endometriotic tissues, the authors analyze the expression of aromatase and E2-inactivating estrogen sulfotransferase (EST) in paired biopsies obtained simultaneously from the endometrium and from endometrial lesions of each of 35 patients with peritoneal or ovarian endometriosis and in cycling endometria from 33 women without endometriosis. Protein localization was demonstrated by immunohistochemistry. Aromatase expression was found in endometriotic glands in 32 of 35 cases and was elevated in comparison to corresponding uterine endometria (25 of 35 cases, P = .021, chi(2) test). The difference was even more pronounced when uterine endometria from endometriosis patients were compared with that of healthy controls (8 of 33 cases, P < .001, chi(2) test). The EST levels were essentially unchanged. The elevated expression of aromatase in eutopic and ectopic endometrium from patients with endometriosis in the presence of comparable EST provides further evidence for unopposed local biosynthesis of estrogens in endometriosis.
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Expression of P450 aromatase is increased in adenomyotic tissue and in ectopic and eutopic endometrium of women with endometriosis.
“The expression of the P450 aromatase is increased in adenomyotic tissue and in the ectopic and eutopic endometrium of women with endometriosis [35–41].”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [39]
Similarity of molecular biology of TIAR in various tissues with that described in endometriosis strongly suggests that this represents the common underlying mechanisms of both processes.
“The similarity of the molecular biology of TIAR in various tissues with that described in endometriosis [39–41, 59–62] strongly suggests that this represents the common underlying mechanisms of both processes”
From The pathophysiology of endometriosis and adenomyosis, tissue injury and repair (2009) · cites this paper as [39]
Eutopic endometrium often stained aromatase in endometriosis patients, detectable by IHC in 66/92 patients but also in endometrium of 13/14 (95%) patients with severe dysmenorrhea but free from endometriosis.
“Eutopic endometrium often stained aromatase in endometriosis patients ( 18 , 21 ), being detectable by IHC in 66/92 patients but also in the endometrium of 13/14 (95%) patients with severe dysmenorrhea but free from endometriosis.”
From Is intracrinology of endometriosis relevant in clinical practice? A systematic review on estrogen metabolism (2022) · cites this paper as [18]
In asymptomatic women (control group), aromatase expression was not detected.
“Interesting in asymptomatic women (control group) aromatase expression was not detected ( 18 ).”
From Is intracrinology of endometriosis relevant in clinical practice? A systematic review on estrogen metabolism (2022) · cites this paper as [18]
Positive immunohistochemical expression of aromatase was found in 32/35 patients with mild to moderate endometriosis according to revised AFS classification.
“and in 32/35 patients with mild to moderate endometriosis according to the revised American Fertility Society (AFS) classification ( 18 ).”
From Is intracrinology of endometriosis relevant in clinical practice? A systematic review on estrogen metabolism (2022) · cites this paper as [18]
In patients with mild and moderate endometriosis, no significant differences were found between SULT1E1 protein levels in uterine and ectopic samples compared to endometrium of healthy women.
“The evaluation of patients with mild and moderate endometriosis shows no significant differences between the expression levels of SULT1E1 protein in uterine and ectopic samples in comparison to the endometrium of healthy women ( 18 ).”
From Is intracrinology of endometriosis relevant in clinical practice? A systematic review on estrogen metabolism (2022) · cites this paper as [18]
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Roles of regulatory T cells in endometriosis-associated infertility
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- Authors
- Hudelist, G., Czerwenka, K., Keckstein, J., Haas, C., Fink-Retter, A., Gschwantler-Kaulich, D., Kubista, E., & Singer, C. F.
- Affiliations
- University of Vienna (AT)
- Corresponding author
- Singer, C. F.
- Venue
- Reproductive Sciences
- Published
- 2007-12
- Volume
- 14
- Issue
- 8
- Pages
- 798-805
- ISSN
- 1933-7191 (ISSN-L)
- 1933-7205
- OpenAlex
- W2097421553
- Cited by
- 70
- References
- 32
- Citations by year
- 2026: 2 · 2024: 2 · 2022: 3 · 2021: 2 · 2020: 2 · 2019: 3 · 2018: 3 · 2017: 1 · 2016: 8 · 2015: 6 · 2014: 2 · 2013: 3 · 2012: 4
- FWCI
- 7.00
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Reproductive Sciences (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Estrogen and related hormone effects
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Ectopic Pregnancy Diagnosis and Management
- Keywords
- endometriosis, aromatase, estrogen sulfotransferase, estradiol metabolism, eutopic endometrium, ectopic endometrium, endometrioma, peritoneal endometriosis, estrogen inactivation, endometriotic lesions
- MeSH terms
- Adult, Aromatase, Biopsy, Endometriosis, Estradiol, Female, Humans, Immunohistochemistry, Sulfotransferases
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