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Promoter Hypermethylation of Progesterone Receptor Isoform B (PR-B) in Adenomyosis and Its Rectification by a Histone Deacetylase Inhibitor and a Demethylation Agent

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Abstract

Adenomyosis is a fairly common gynecologic disease with unknown pathogenesis. We sought to investigate as to whether the promoter of progesterone receptor isoform B (PR-B) is hypermethylated in adenomyosis and to investigate the treatment of ectopic endometrial stromal cells with trichostatin A (TSA), a histone deacetylase inhibitor (HDI), and 5-aza-2-deoxycytidine (ADC), a demethylation agent, on PR-B gene and protein expression, and on cell viability. Ectopic endometrial tissue specimens were obtained from 9 women with adenomyosis whereas control endometrial tissue samples were obtained from 8 women with surgically diagnosed benign ovarian cysts but without any clinical history of endometriosis/adenomyosis/myoma. Endometrial stromal cells were isolated, purified, cultured, and analyzed by methylation-specific polymerase chain reaction (PCR), real-time reverse transcriptase PCR (RT-PCR), and Western blot analysis, cell viability assays, and fluorescence-activated cell sorting. We found that none of the normal endometrial stromal cells had PR-B promoter methylation. In contrast, 2 out of 3 ectopic endometrial stromall cells had PR-B hypermethylation (P <.05). The treatment with both TSA and ADC elevated PR-B gene and protein expression in ectopic, but not in normal, endometrial stromal cells. Both TSA and ADC treatment dose-dependently reduced cell viability of ectopic endometrial stromal cells. Trichostatin A and ADC treatment also suppressed the cell cycle progression in ectopic endometrial stromal cells. Thus, this study provides the first piece of evidence that adenomyosis has epigenetic aberration and may also be an epigenetic disease amenable to rectification by pharmacological means. This perspective may shed new light onto the pathogenesis of adenomyosis and lead to novel ways to treat the disease.

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References

  1. Bergeron C, Amant F, Ferenczy A. Pathology and physiopathology of adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4): 511–521.

    Article  PubMed  Google Scholar 

  2. Farquhar C, Brosens I. Medical and surgical management of adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4): 603–616.

    Article  PubMed  Google Scholar 

  3. Kitawaki J. Adenomyosis: the pathophysiology of an oestrogen-dependent disease. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):493–502.

    Article  PubMed  Google Scholar 

  4. Grow DR, Filer RB. Treatment of adenomyosis with long-term GnRH analogues: a case report. Obstet Gynecol. 1991;78(3 pt 2):538–539.

    CAS  PubMed  Google Scholar 

  5. Cho S, Nam A, Kim H, et al. Clinical effects of the levonorgestrelreleasing intrauterine device in patients with adenomyosis. Am J Obstet Gynecol. 2008;198(4):373.e1–373.e7.

    Article  CAS  Google Scholar 

  6. Ota H, Igarashi S, Hatazawa J, Tanaka T. Is adenomyosis an immune disease? Hum Reprod Update. 1998;4(4):360–367.

    Article  CAS  PubMed  Google Scholar 

  7. Maia H. Jr., Maltez A, Studart E, Athayde C, Coutinho EM. Effect of menstrual cycle and hormonal treatment on ki-67 and bcl-2 expression and adenomyosis. Gynecol Endocrinol. 2005;20(3): 127–131.

    Article  CAS  PubMed  Google Scholar 

  8. Kunz G, Beil D, Huppert P, Noe M, Kissler S, Leyendecker G. Adenomyosis in endometriosis-prevalence and impact on fertility. Evidence from magnetic resonance imaging. Hum Reprod. 2005; 20(8):2309–2316.

    CAS  PubMed  Google Scholar 

  9. Kunz G, Herbertz M, Beil D, Huppert P, Leyendecker G. Adenomyosis as a disorder of the early and late human reproductive period. Reprod Biomed Online. 2007;15(6):681–685.

    Article  CAS  PubMed  Google Scholar 

  10. Wu MY, Ho HN. The role of cytokines in endometriosis. Am J Reprod Immunol. 2003;49(5):285–296.

    Article  PubMed  Google Scholar 

  11. Ulukus M, Ulukus EC, Tavmergen Goker EN, Tavmergen E, Zheng W, Arici A. Expression of interleukin-8 and monocyte chemotactic protein 1 in women with endometriosis. Fertil Steril. 2009;91(3):687–693.

    Article  CAS  PubMed  Google Scholar 

  12. Ota H, Igarashi S, Sasaki M, Tanaka T. Distribution of cyclooxygenase-2 in eutopic and ectopic endometrium in endometriosis and adenomyosis. Hum Reprod. 2001;16(3):561–566.

    Article  CAS  PubMed  Google Scholar 

  13. Ota H, Igarashi S, Hatazawa J, Tanaka T. Immunohistochemical assessment of superoxide dismutase expression in the endometrium in endometriosis and adenomyosis. Fertil Steril. 1999;72(1):129–134.

    Article  CAS  PubMed  Google Scholar 

  14. Ota H, Igarashi S, Hatazawa J, Tanaka T. Endothelial nitric oxide synthase in the endometrium during the menstrual cycle in patients with endometriosis and adenomyosis. Fertil Steril. 1998;69(2):303–308.

    Article  CAS  PubMed  Google Scholar 

  15. Ota H, Igarashi S, Kato N, Tanaka T. Aberrant expression of glutathione peroxidase in eutopic and ectopic endometrium in endometriosis and adenomyosis. Fertil Steril. 2000;74(2):313–318.

    Article  CAS  PubMed  Google Scholar 

  16. Ota H, Igarashi S, Tanaka T. Xanthine oxidase in eutopic and ectopic endometrium in endometriosis and adenomyosis. Fertil Steril. 2001;75(4):785–790.

    Article  CAS  PubMed  Google Scholar 

  17. Bulun SE, Cheng YH, Yin P, et al. Progesterone resistance in endometriosis: link to failure to metabolize estradiol. Mol Cell Endocrinol. 2006;248(1–2):94–103.

    Article  CAS  PubMed  Google Scholar 

  18. Guo SW. Nuclear factor-kappab (NF-kappaB): an unsuspected major culprit in the pathogenesis of endometriosis that is still at large? Gynecol Obstet Invest. 2007;63(2):71–97.

    Article  CAS  PubMed  Google Scholar 

  19. Hardy DB, Janowski BA, Corey DR, Mendelson CR. Progesterone receptor plays a major antiinflammatory role in human myometrial cells by antagonism of nuclear factor-kappaB activation of cyclooxygenase 2 expression. Mol Endocrinol. 2006;20(11): 2724–2733.

    Article  CAS  PubMed  Google Scholar 

  20. Kalkhoven E, Wissink S, van der Saag PT, van der Burg B. Negative interaction between the RelA(p65) subunit of NF-kappaB and the progesterone receptor. J Biol Chem. 1996;271(11): 6217–6224.

    Article  CAS  PubMed  Google Scholar 

  21. Yamamoto K, Arakawa T, Ueda N, Yamamoto S. Transcriptional roles of nuclear factor kappa B and nuclear factor-interleukin-6 in the tumor necrosis factor alpha-dependent induction of cyclooxygenase-2 in MC3T3-E1 cells. J Biol Chem. 1995; 270(52):31315–31320.

    Article  CAS  PubMed  Google Scholar 

  22. Nie J, Lu Y, Liu X., Guo SW. Immunoreactivity of progesterone receptor isoform B, nuclear factor kappaB, and IkappaBalpha in adenomyosis. Fertil Steril.2009;92(3):886–889.

    Article  PubMed  CAS  Google Scholar 

  23. Wu Y, Strawn E, Basir Z, Halverson G, Guo SW. Promoter hypermethylation of progesterone receptor isoform B (PR-B) in endometriosis. Epigenetics. 2006;1(2):106–111.

    Article  PubMed  Google Scholar 

  24. Ryan IP, Schriock ED, Taylor RN. Isolation, characterization, and comparison of human endometrial and endometriosis cells in vitro. J Clin Endocrinol Metab. 1994; 78(3):642–649.

    CAS  PubMed  Google Scholar 

  25. Rossi MJ, Chegini N, Masterson BJ. Presence of epidermal growth factor, platelet-derived growth factor, and their receptors in human myometrial tissue and smooth muscle cells: their action in smooth muscle cells in vitro. Endocrinology. 1992;130(3): 1716–1727.

    CAS  PubMed  Google Scholar 

  26. Hirota Y, Osuga Y, Hirata T, et al. Possible involvement of thrombin/protease-activated receptor 1 system in the pathogenesis of endometriosis. J Clin Endocrinol Metab. 2005;90(6): 3673–3679.

    Article  CAS  PubMed  Google Scholar 

  27. Liu Y, Peterson DA, Kimura H, Schubert D. Mechanism of cellular 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) reduction. J Neurochem. 1997; 69(2):581–593.

    Article  CAS  PubMed  Google Scholar 

  28. Serafim TL, Oliveira PJ, Sardao VA, Perkins E, Parke D, Holy J. Different concentrations of berberine result in distinct cellular localization patterns and cell cycle effects in a melanoma cell line. Cancer Chemother Pharmacol. 2008;61(6):1007–1018.

    Article  CAS  PubMed  Google Scholar 

  29. Sakaguchi H, Fujimoto J, Hong BL, Nakagawa Y, Tamaya T. Drastic decrease of progesterone receptor form B but not A mRNA reflects poor patient prognosis in endometrial cancers. Gynecol Oncol. 2004;93(2):394–399.

    Article  CAS  PubMed  Google Scholar 

  30. Sasaki M, Dharia A, Oh BR, Tanaka Y, Fujimoto S, Dahiya R. Progesterone receptor B gene inactivation and CpG hypermethylation in human uterine endometrial cancer. Cancer Res. 2001; 61(1): 97–102.

    CAS  PubMed  Google Scholar 

  31. Tukey JW. Exploratory Data Analysis. Reading, MA: Addison-Wesley; 1977.

    Google Scholar 

  32. Inhaka R, Gentleman RR. R: a language for data analysis and graphics. J Comput Graph Stat. 1996;5(3):1923–1927.

    Google Scholar 

  33. Matalliotakis IM, Kourtis AI, Panidis DK. Adenomyosis. Obstet Gynecol Clin North Am. 2003;30(1):63–82, viii.

    Article  CAS  PubMed  Google Scholar 

  34. Devlieger R, D’Hooghe T, Timmerman D. Uterine adenomyosis in the infertility clinic. Hum Reprod Update. 2003;9(2):139–147.

    Article  PubMed  Google Scholar 

  35. Peric H, Fraser IS. The symptomatology of adenomyosis. Best Pract Res Clin Obstet Gynaecol. 2006;20(4):547–555.

    Article  CAS  PubMed  Google Scholar 

  36. Guo SW. Epigenetics of endometriosis. Mol Hum Reprod. 2009;15(10):587–607.

    Article  CAS  PubMed  Google Scholar 

  37. Wen DX, Xu YF, Mais DE, Goldman ME, McDonnell DP. The A and B isoforms of the human progesterone receptor operate through distinct signaling pathways within target cells. Mol Cell Biol. 1994;14(12):8356–8364.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  38. Robertson KD, Wolffe AP. DNA methylation in health and disease. Nat Rev Genet. 2000;1(1):11–19.

    Article  CAS  PubMed  Google Scholar 

  39. Liu X, Guo SW. A pilot study on the off-label use of valproic acid to treat adenomyosis. Fertil Steril. 2008;89(1):246–250.

    Article  CAS  PubMed  Google Scholar 

  40. Matsuoka H, Fujimura T, Mori H, Aramori I, Mutoh S. Mechanism of HDAC inhibitor FR235222-mediated IL-2 transcriptional repression in Jurkat cells. Int Immunopharmacol. 2007;7(11): 1422–1432.

    Article  CAS  PubMed  Google Scholar 

  41. Yang AS, Estecio MR, Garcia-Manero G, Kantarjian HM, Issa JP. Comment on “Chromosomal instability and tumors promoted by DNA hypomethylation” and “Induction of tumors in nice by genomic hypomethylation.”. Science. 2003;302(5648): 1153;author reply 1153.

    Article  CAS  PubMed  Google Scholar 

  42. Lubbert M, Wijermans P, Kunzmann R, et al. Cytogenetic responses in high-risk myelodysplastic syndrome following low-dose treatment with the DNA methylation inhibitor 5-aza-2’-deoxycytidine. Br J Haematol. 2001;114(2):349–357.

    Article  CAS  PubMed  Google Scholar 

  43. Garcia-Manero M, Santana GT, Alcazar JL. Relationship between microvascular density and expression of vascular endothelial growth factor in patients with ovarian endometriosis. J Womens Health (Larchmt). 2008;17(5):777–782.

    Article  Google Scholar 

  44. Wu Y, Starzinsky-Powitz A, Guo SW. Constitutive and TNFα-stimulated activation of nuclear factor κB (NF-κB) in immortalized endometriotic cells and their suppression by trichostatin A (TSA). Gynecol Obstet Invest. 2010;70(1):23–33.

    Article  CAS  PubMed  Google Scholar 

  45. Gonzalez-Ramos R, Donnez J, Defrere S, et al. Nuclear factor-kappa B is constitutively activated in peritoneal endometriosis. Mol Hum Reprod. 2007;13(7):503–509.

    Article  CAS  PubMed  Google Scholar 

  46. Liu XS, Yuan L, Guo SW. Vaproic acid as a therapy for adenomyosis: a comparative case series. Reprod Sci. IN PRESS.

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Correspondence to Sun-Wei Guo PhD.

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Nie, J., Liu, X. & Guo, SW. Promoter Hypermethylation of Progesterone Receptor Isoform B (PR-B) in Adenomyosis and Its Rectification by a Histone Deacetylase Inhibitor and a Demethylation Agent. Reprod. Sci. 17, 995–1005 (2010). https://doi.org/10.1177/1933719110377118

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