Phenotypic characterization of adenomyosis occurring at the inner and outer myometrium

• Published in: PloS one Vol. 12; no. 12; p. e0189522
• Main Authors: Kishi, Yohei, Shimada, Keiji, Fujii, Tomomi, Uchiyama, Tomoko, Yoshimoto, Chiharu, Konishi, Noboru, Ohbayashi, Chiho, Kobayashi, Hiroshi
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 18.12.2017; Public Library of Science (PLoS)
• Subjects: Biology and Life Sciences; Collagen; Collagen (type I); Cytoskeleton; Desmin; Development and progression; Endometriosis; Extracellular matrix; Fibrosis; Gene expression; Glands; Gynecology; Health aspects; Immunohistochemistry; Internet; Localization; Medicine and Health Sciences; Muscles; Myometrium; Myosin; NMR; Nuclear magnetic resonance; Obstetrics; Pathology; Phosphorylation; Physiological aspects; Proteins; Receptors; Research and Analysis Methods; Signaling; Smad3 protein; Smooth muscle; Staining; Transforming growth factors; Uterus; Japan
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0189522

To estimate the phenotypic characterization of fibrotic process in adenomyosis occurring at the inner or the outer myometrium. Eight cases of adenomyosis occurring at the inner myometrium (Subtype I) and 10 cases of adenomyosis occurring at the outer myometrium (Subtype II), and 10 normal counterparts were used in this study. A immunohistochemical study for smooth muscle cells (SMCs) was performed using cytoskeletal proteins, Type I and III collagen, TGF-β and its signaling molecules. An increased expression of Type I collagen was observed in the extracellular matrix of adenomyotic foci. In normal uteri, immunostaining of SMC differentiation marker proteins (Desmin, Smoothelin, Myosin heavy chain (MHC)) were absent or only found in low numbers at the inner myometrium, while all of these marker proteins were clearly stained at the outer myometrium. In both types of adenomyotic foci, Desmin, Smoothelin, and MHC commonly showed a negative staining at the adjacent area to the glands. A significant staining of Non-muscle myosin IIB, TGF-β, and phosphorylated TGF-β type I receptors were found only at the SMCs of Subtype II adenomyosis. The Smad3/2 ratio of Subtype II adenomyosis was significantly higher than that of Subtype I. The inner myometrium of normal uteri was composed of undifferentiated phenotypes of SMCs, while the outer myometrium was composed of terminally differentiated SMCs. Various fibrotic processes have been suggested in the development of uterine adenomyosis. Distinct expression patterns of fibrosis related proteins have been shown to be implicated with differences in the subtypes of adenomyosis.