Progesterone Receptor Isoform A But Not B Is Expressed in Endometriosis
Abstract
We previously demonstrated that 17beta hydroxysteroid dehydrogenase type 2, the enzyme that inactivates estradiol to estrone, is expressed in luteal eutopic endometrium in response to progesterone but not in simultaneously biopsied peritoneal endometriotic tissue. This molecular evidence of progesterone resistance, together with the clinical observation of resistance of endometriosis to treatment with progestins, led us to determine the levels of progesterone receptor (PR) isoforms PR-A and PR-B in eutopic endometrial and extra-ovarian endometriotic tissues. It was proposed that progesterone action on target genes is mediated primarily by homodimers of PR-B, whereas the truncated variant PR-A acts as a repressor of PR-B function. Immunoprecipitation, followed by Western blot analysis, was performed to detect bands specific for PR-A and PR-B in paired samples of endometriotic and eutopic endometrial tissues simultaneously biopsed from 18 women undergoing laparoscopy during various phases of the menstrual cycle. PR-B was present in 17 of 18 eutopic endometrial samples, and its level increased in the preovulatory phase, as expected, whereas PR-A was detected in all samples (n = 18) with a similar, but less prominent, cyclic variation in its levels. In endometriotic samples, however, no detectable PR-B could be demonstrated, whereas PR-A was detected in all samples (n = 18), albeit in much lower levels and without any cyclic variation in contrast with the eutopic endometrium. Levels of PR-A and PR-B in endometriotic and eutopic endometrial tissues were determined and compared after normalization to total protein and estrogen receptor-alpha levels. Using RNase protection assay, we also demonstrated indirectly that only PR-A transcripts were present in endometriotic tissue samples (n = 8), whereas both PR-A and PR-B transcripts were readily detectable in all eutopic endometrial samples (n = 8). This was indicative that failure to detect PR-B protein in endometriotic tissues is due to the absence of PR-B transcripts. We conclude that progesterone resistance in endometriotic tissue from laboratory and clinical observations may be accounted for by the presence of the inhibitory PR isoform PR-A and the absence of the stimulatory isoform PR-B.
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A decreased PR-B/PR-A ratio has been demonstrated in ectopic tissue and in eutopic endometrium of women with endometriosis, albeit not consistently.
“A decreased PR-B/PR-A ratio has been demonstrated not only in ectopic tissue (Attia et al., 2000), but also in eutopic endometrium of women with endometriosis (Igarashi et al., 2005), albeit not consistently (Bukulmez et al., 2008).”
From “Waiting for Godot”: a commonsense approach to the medical treatment of endometriosis (2011) · cites this paper as Attia et al., 2000
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- Authors
- Attia, G. R.
- Affiliations
- The University of Texas Southwestern Medical Center (US)
- Corresponding author
- Attia, G. R.
- Venue
- Journal of Clinical Endocrinology & Metabolism
- Publisher
- The Endocrine Society
- Published
- 2000-08-01
- Volume
- 85
- Issue
- 8
- Pages
- 2897-2902
- ISSN
- 0021-972X (ISSN-L)
- OpenAlex
- W2030686715
- Cited by
- 488
- References
- 34
- Citations by year
- 2026: 2 · 2025: 15 · 2024: 17 · 2023: 13 · 2022: 23 · 2021: 21 · 2020: 19 · 2019: 18 · 2018: 20 · 2017: 20 · 2016: 25 · 2015: 20 · 2014: 26 · 2013: 21 · 2012: 32
- FWCI
- 11.96
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Journal of Clinical Endocrinology & Metabolism (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 › Obstetrics and Gynecology › Endometrial and Cervical Cancer Treatments
- Keywords
- endometriosis, progesterone receptor isoforms, progesterone receptor A, progesterone receptor B, progesterone resistance, eutopic endometrium, 17β-hydroxysteroid dehydrogenase type 2, menstrual cycle, progestin resistance, gene expression
- MeSH terms
- Adult, Endometriosis, Endometrium, Female, Humans, Menstrual Cycle, Receptors, Progesterone, RNA, Messenger, Transcription, Genetic, Blotting, Western, Dimerization
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