Jane E. Girling

Recent advances in endometrial angiogenesis research.

This review summarises recent research into the mechanisms and regulation of endometrial angiogenesis. Understanding of when and by what mechanisms angiogenesis occurs during the menstrual cycle is limited, as is knowledge of how it is regulated. Significant endometrial endothelial cell proliferation occurs at all stages of the menstrual cycle in humans, unlike most animal models where a more precise spatial relationship exists between endothelial cell proliferation and circulating levels of oestrogen and progesterone. Recent stereological data has identified vessel elongation as a major endometrial angiogenic mechanism in the mid-late proliferative phase of the cycle. In contrast, the mechanisms that contribute to post-menstrual repair and secretory phase remodelling have not yet been determined. Both oestrogen and progesterone/progestins appear to have paradoxical actions, with recent studies showing that under different circumstances both can promote as well as inhibit endometrial angiogenesis. The relative contribution of direct versus indirect effects of these hormones on the vasculature may help to explain their pro- or anti-angiogenic activities. Recent work has also identified the hormone relaxin as a player in the regulation of endometrial angiogenesis. While vascular endothelial growth factor (VEGF) is fundamental to endometrial angiogenesis, details of how and when different endometrial cell types produce VEGF, and how production and activity is controlled by oestrogen and progesterone, remains to be elucidated. Evidence is emerging that the different splice variants of VEGF play a major role in regulating endometrial angiogenesis at a local level. Intravascular neutrophils containing VEGF have been identified as having a role in stimulating endometrial angiogenesis, although other currently unidentified mechanisms must also exist. Future studies to clarify how endometrial angiogenesis is regulated in the human, as well as in relevant animal models, will be important for a better understanding of diseases such as breakthrough bleeding, menorrhagia, endometriosis and endometrial cancer.

Toll-like receptors in the gonads and reproductive tract: emerging roles in reproductive physiology and pathology.

Interactions between the immune system and reproductive system have important consequences for fertility and reproductive health in general. There is increasing evidence that many of the interactions between the immune and reproductive systems involve the Toll‐like receptors (TLRs). While there is no doubt that TLRs are important in providing protection against infection in the reproductive tract, there is increasing evidence for the involvement of TLRs in more basic pathology and physiology of reproduction. In the female, TLRs have been implicated in critical aspects of ovarian, endometrial and placental function, as well as in ovarian cancer, pelvic inflammatory disease, intrauterine growth restriction, pre‐eclampsia and preterm birth. In the male, TLRs appear to play a role in the control of testicular steroidogenesis and spermatogenesis in disease and, potentially, during normal function, as well. Recent studies also have begun to highlight the role of various TLRs in the aetiology of prostatitis and prostatic cancer. Given the nascent state of knowledge concerning this important area, it is clear that more studies are needed, which should provide valuable new insights into the biology of the TLRs and reproductive function in general.

Endometrial Angiogenesis, Vascular Maturation, and Lymphangiogenesis

Angiogenesis, arteriogenesis or vessel maturation, and lymphangiogenesis comprise a continuum of vascular development, with overlap and interaction between the mechanisms by which they are controlled. These processes are of clinical interest because they play roles in endometrial repair, placental development, and in gynecological disorders including endometrial cancer, endometriosis and abnormal uterine bleeding. Using mouse models we have shown that estrogen can be either proangiogenic or antiangiogenic in endometrium. Progesterone alone is proangiogenic, although this can be moderated by pretreatment with estrogen. Arteriogenesis also increases in response to progesterone, and this effect is not inhibited by estrogen. Lymphatics account for 13% of all vessels in the human functionalis compared to 57% in the basalis. Many of the basalis lymphatic vessels are closely associated with spiral arterioles and this intimate connection may provide a mechanism for paracrine communication between the functionalis and the arteries supplying the endometrium.

Regulation of endometrial vascular remodelling: role of the vascular endothelial growth factor family and the angiopoietin-TIE signalling system.

Angiogenesis, lymphangiogenesis and vascular maturation occur on a regular, physiological basis in human endometrium. These processes form part of a continuum of vascular remodelling involving numerous regulatory factors. Key factors include vascular endothelial growth factor (VEGF)A, VEGFC and VEGFD, and their associated receptors VEGFR1, VEGFR2 and VEGFR3. A second group of vascular regulatory proteins belongs to the angiopoietin (ANG)-TIE system. Although members of the VEGF family and the ANG-TIE system are represented in the endometrium, our understanding of how these different molecules interact to regulate remodelling of the blood and lymphatic vasculature present in the endometrium is still limited. A review of the current information is provided.

Oviductal structure in a viviparous New Zealand gecko, Hoplodactylus maculatus

Oviductal structure is described in New Zealands common gecko, Hoplodactylus maculatus, over four reproductive stages (early/mid‐vitellogenesis, late vitellogenesis, early pregnancy, late pregnancy), using light, scanning electron, and transmission electron microscopy. Five regions of the oviduct are recognized: infundibulum, uterine tube, isthmus, uterus, and vagina. Up to three cell types make up the luminal epithelium of the oviduct: ciliated, nonciliated, and bleb cells. The function of bleb cells (seen in the infundibulum only) is unknown, but observation of these cells using transmission electron microscopy suggests that they are involved in secretory activity. Mucosal glands in the uterine tube possess large numbers of secretory granules of varying electron densities. Additionally, these glands appear to function as sperm storage tubules. Numerous sperm are seen in the glands during late vitellogenesis and early pregnancy. Very few uterine mucosal (shell) glands are seen during vitellogenesis, which is consistent with the observation that only a fine shell membrane covers the egg during early pregnancy. By late pregnancy, extraembryonic membranes lie adjacent to the uterus allowing the formation of the omphalo‐ and chorioallantoic placentas. Maximum cell height in the luminal epithelium is seen during vitellogenesis. The maximum percentage of ciliated cells making up the epithelial layer is seen during pregnancy. The low number of uterine mucosal glands seen in H. maculatus is a feature typical of other viviparous reptiles described, despite independent evolutions of viviparity. Although oviductal structure has been described in the literature for various reptiles, several ultrastructural features seen in this study highlight the lack of detailed understanding of this tissue. J. Morphol. 234:51‐68, 1997.

In vitro progesterone production by maternal and embryonic tissues during gestation in the southern snow skink (Niveoscincus microlepidotus).

The southern snow skink, Niveoscincus microlepidotus, has a protracted gestation, lasting approximately one year. Ovulation occurs in spring (November) and embryonic development is completed by early autumn (March); however, birth does not occur until the following spring. Previous studies have shown that plasma progesterone concentration peaks in preovulatory females (spring, October), remains high during early gestation, and decreases to basal by autumn. In vitro progesterone production by corpora lutea, non-luteal ovary, anterior oviduct, placental tissues, muscle, and embryonic adrenal-gonads from N. microlepidotus was assessed throughout gestation. Tissues were incubated with or without the precursor pregnenolone for 3h at 24 degrees C; the resulting media were analysed for progesterone using radioimmunoassay. In vitro progesterone production by corpora lutea in media only was high during early gestation, dropping to basal by autumn. Maternal adrenal glands produced progesterone in vitro in media only throughout gestation; however, the pattern of production did not correlate with plasma concentrations and may represent steroid that is normally converted to corticosterone. Non-luteal ovary, anterior oviduct, placental tissues, muscle, and embryonic adrenal-gonads produced minimal progesterone in media only, but were able to convert pregnenolone to progesterone; this suggests steroid metabolic capability within these tissues. Further research is needed to address the possible endocrine role(s) of placental and embryonic tissues during gestation in viviparous squamates.

Lymphatics in the human endometrium disappear during decidualization

BACKGROUND The mammalian placenta plays a central role in maternal tolerance of the semi-allogeneic fetus and fluid balance between the maternal and fetal compartments. The lymphatics play a role in both these function. The aim of this study was to describe the distribution of lymphatic vessels in human decidua, with particular focus on the lymphatics that surround remodelling spiral arteries during decidualization and trophoblast invasion. METHODS Placental bed and non-placental bed (decidua parietalis) biopsies were obtained from 41 women undergoing elective termination of pregnancy at 6-18 weeks gestational age as well as placental bed biopsies from 5 women undergoing elective Caesarean section at term. In addition to routine haematoxylin and eosin staining, double immunohistochemical labelling was performed on serial 3-µm sections to identify lymphatic vessels in conjunction with one of the following: blood vessels, smooth muscle, epithelial and trophoblast cells or proliferating cells. Representative photomicrographs of all sections were obtained from a total of 273 areas (46 samples, average 6 range 3-15 areas per sample). Descriptive findings of the organization of lymphatics in human placental bed and decidua parietalis were made from a total of 1638 images. RESULTS Lymphatic vessels positive for podoplanin were abundant in non-decidualized hypersecretory endometrium at all stages of gestation. By contrast, the decidua was nearly always devoid of lymphatics. In some samples, structures that appeared to be regressing lymphatics could be observed at the boundary between non-decidualized hypersecretory and decidualized endometrium. Lymphatic vessels were notably absent from the vicinity of spiral arteries that were surrounded by decidualized stromal cells. Lymphatic vessels in non-decidualized hypersecretory endometrium appeared larger and more elongated as gestation progressed. Proliferating lymphatic vascular endothelial cells were identified in both large vessels, and in streaks of D2-40 positive cells that could have been newly forming lymphatic vessels. Placental bed lymphatics exhibited limited and variable staining with LYVE-1 at all stages of pregnancy apart from term. CONCLUSIONS We have made novel observations on lymphatics in the placental bed and their relationship with other structures throughout pregnancy. Endometrial stromal cell decidualization results in a loss of lymphatics, with this phenomenon being particularly apparent around the spiral arteries.

Delayed ovulation and parturition in a viviparous alpine lizard (Niveoscincus microlepidotus): morphological data and plasma steroid concentrations

The southern snow skink, Niveoscincus microlepidotus, exhibits an unusual biennial reproductive cycle with an extended gestation period of approximately 1 year. Morphological data were gathered on a monthly basis, providing a detailed picture of the reproductive cycle. Vitellogenesis begins in spring, immediately after parturition. Maximum follicular diameter is reached before the winter hibernation period and ovulation occurs the following spring. Embryos are fully developed and reach maximum size by early autumn. Yolk reserves are depleted before winter. Birth of between one and four young occurs the following spring. Plasma progesterone concentrations are low (2.7 +/- 0.9 ng mL(-1)) in post-partum females, begin to rise in autumn in vitellogenic females and peak (38.5 +/- 7.9 ng mL(-1)) in pre-ovulatory females after hibernation. Concentrations are high (15.4 +/- 5.9 ng mL(-1)) in early pregnancy and decline to basal levels before winter and well before birth in spring. Plasma oestradiol concentrations peak during vitellogenesis (1.0 +/- 0.3 ng mL(-1)) and decline to basal levels during pregnancy (0.2 +/- 0.03 ng mL(-1)). A second oestradiol peak occurs before parturition (0.7 +/- 0.2 ng mL(-1)). Thus, functional completion of vitellogenesis and gestation is achieved by autumn in successive years. The mechanisms that defer ovulation and parturition by a further six months are unknown.

Enhanced Uterine Artery Stiffness in Aged Pregnant Relaxin Mutant Mice Is Reversed with Exogenous Relaxin Treatment

ABSTRACT Pregnancy is associated with a progressive remodeling of the uterine artery. This adaptation is influenced by local and systemic pregnancy-dependent factors. We recently demonstrated that the peptide hormone relaxin mediates uterine artery remodeling in late pregnant rats. The objective of this study in relaxin gene knockout (Rln−/−) mice was to test the hypothesis that relaxin deficiency throughout pregnancy disrupts uterine artery remodeling, an effect that is exacerbated by aging and reversed with relaxin treatment. Passive mechanical wall properties and extracellular matrix components were measured using pressure myography, quantitative PCR, and zymography in uterine arteries from pregnant wild-type (Rln+/+) and Rln−/− mice aged 5 and 8 mo on Days 12.5 and 17.5 pregnancy. In a second study, 8-mo-old Rln−/− mice received either placebo or human recombinant relaxin subcutaneously for 5 days from Day 12.5 pregnancy. Relaxin deficiency in pregnancy did not alter uterine artery remodeling in young mice. However, remodeling was impaired in older pregnant Rln−/− mice, resulting in significantly stiffer uterine arteries. Uterine arteries of aged Rln−/− pregnant mice had increased expression of elastin, whereas several matrix metalloproteinases and cell adhesion molecules were decreased relative to Rln+/+ mice. Fetal weight was also significantly reduced in Rln−/− mice in late pregnancy in both young and old dams, whereas placental weight was unchanged. Arterial stiffness and reduced fetal weight were reversed after relaxin treatment. In conclusion, relaxin deficiency compromises uterine artery remodeling in older pregnant females, increasing the risk of pregnancy complications such as hypertension and intrauterine growth restriction.

Expression patterns of activin, inhibin and follistatin variants in the adult male mouse reproductive tract suggest important roles in the epididymis and vas deferens

Activin A and its inhibitors follistatin and inhibin play key roles in development and function of the male reproductive tract. Quantitative (q) polymerase chain reaction (PCR) was used to evaluate the expression of Inhba (the gene encoding activin A subunits), Inha and Inhbb (genes encoding the inhibin B subunits), as well as the genes for follistatin (Fst) and follistatin-like 3 (Fstl3) and the activin receptor subunits, in the male mouse reproductive tract. A qPCR assay that discriminated between the two follistatin variants of Fst288 (tissue-bound form) and Fst315 (circulating) was established. Activin A protein was measured by ELISA, whereas the inhibin α-subunit and total follistatin proteins were measured by radioimmunoassay (RIA). A screen of 22 tissues demonstrated tissue-specific regulation of the follistatin variants, with Fst288 highly expressed in the vas deferens and Fst315 most highly expressed in the skin. The expression of Fst288 and Fst315 and follistatin protein levels increased progressively from the testis through to the distal vas deferens. Inhba and the activin receptors were highly expressed in the epididymis, but activin A protein was elevated in both the epididymis and vas deferens. Inhibin α-subunit mRNA and protein and Inhbb expression were highest in the testis. These results indicate a role for activin A within the epididymis, but also that activin A bioactivity may be increasingly inhibited by follistatin distally along the male reproductive tract.