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HOXB4 Immunoreactivity in Endometrial Tissues From Women With or Without Endometriosis

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Abstract

Endometriosis is a common disease characterized by the presence of ectopic endometrial tissue. Although the pathogenesis of endometriosis remains unclear, several factors have been implicated, including the dysregulation of homeobox (HOX) genes. Our objective was to investigate the localization and immunoreactivity of HOXB4 in endometrial tissues from women with or without endometriosis. We studied samples of eutopic endometrium (EE), endometriomas (Eoma), superficial endometriosis (SE), and deep infiltrating endometriosis (DIE) from 34 women with endometriosis, as well as eutopic endometrium from 38 women without endometriosis (EC). HOXB4 localization and immunoreactivity was assessed using immunohistochemistry and histoscore analysis. Data were analyzed with and without stratification by menstrual cycle phase. HOXB4 protein was present in the nuclei of endometrial glandular epithelial cells but not in stromal cells. HOXB4 immunoreactivity was reduced in DIE samples compared to all other groups. A smaller reduction in HOXB4 immunoreactivity was observed in SE samples compared to EC samples. HOXB4 immunoreactivity was significantly greater in proliferative compared to secretory phase samples in the EC group but not in EE, Eoma, or DIE groups. Among only proliferative phase samples, HOXB4 immunoreactivity was reduced in EE, Eoma, and DIE groups compared to EC. Based on these data, we suggest that an impaired capacity of eutopic and ectopic endometrial tissue to upregulate levels of HOXB4 during the proliferative phase may play a role in the pathogenesis of endometriosis and that further downregulation of HOXB4 may enhance ectopic implant invasiveness.

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Authors and Affiliations

  1. Department of Obstetrics and Gynaecology, BC Children’s Hospital Research Institute, BC Women’s Hospital, Room D415A, 4500 Oak Street, Vancouver, British Columbia, Canada, V6H 3N1

    Ghadeer M. AlKusayer MBBS, MSc, Bo Peng PhD, Christian Klausen PhD, Sarka Lisonkova MD, PhD, Paul Yong MD, PhD, Peter C. K. Leung PhD & Mohamed A. Bedaiwy MD, PhD

  2. Department of Clinical Sciences, College of Medicine, Princess Nourah Bint Abdulrahman University, Riyadh, Kingdom of Saudi Arabia

    Ghadeer M. AlKusayer MBBS, MSc

  3. Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia, Canada

    Julia R. Pon MD, PhD & Mary Kinloch MD

  4. Sohag University, Sohag, Egypt

    Eman M. S. Muhammad MD, PhD

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  1. Ghadeer M. AlKusayer MBBS, MSc
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  2. Julia R. Pon MD, PhD
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  3. Bo Peng PhD
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  4. Christian Klausen PhD
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Correspondence to Mohamed A. Bedaiwy MD, PhD.

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AlKusayer, G.M., Pon, J.R., Peng, B. et al. HOXB4 Immunoreactivity in Endometrial Tissues From Women With or Without Endometriosis. Reprod. Sci. 25, 950–957 (2018). https://doi.org/10.1177/1933719117732164

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