Julia Spratte

Heparin inhibits TNF-α signaling in human endometrial stromal cells by interaction with NF-κB

Heparins have been shown to be beneficial for the prevention of habitual miscarriages and repeated implantation failure, independently of their function as anticoagulants. The pro-inflammatory cytokine tumor necrosis factor (TNF)-α plays a role in the pathogenesis of these early pregnancy complications. Therefore, we examined the impact of heparin on TNF-α signaling in human endometrial stromal cells (ESCs) in vitro. Human ESCs were isolated from hysterectomy specimens and either used as undifferentiated cells or after decidualization in vitro. Cells were incubated with TNF-α, unfractionated heparin and signaling- and transporter-inhibitors. Interleukin (IL)-8 and -6 were measured using ELISAs and real-time RT-PCR. Nuclear factor of transcription (NF)-κB and its inhibitor IκBα were analyzed by in-cell western assays and confocal microscopy. Activation of NF-κB was determined in nuclear extracts using a specific transcription factor assay. Cellular internalization of heparin was detected by a heparin-uptake assay. Unfractionated heparin significantly suppressed the TNF-α-induced and NF-κB-mediated secretion and expression of IL-8 and -6 as well as other molecules in decidualized and undifferentiated human ESCs. Thereby heparin had no influence on the degradation of IκBα and the phosphorylation of NF-κB, but it inhibited the activity of NF-κB in the nucleus. An active heparin-uptake into the cells was the prerequisite for these heparin-effects. Unfractionated heparin is able to inhibit TNF-α/NF-κB-mediated inflammatory effects in the human endometrium independently of its classical function as an anticoagulant. These observations further underline on a molecular level the beneficial anti-inflammatory effects of heparin in women suffering from implantation disorders even in the absence of a thrombophilia.

Non-apoptotic Fas-induced regulation of cytokines in undifferentiated and decidualized human endometrial stromal cells depends on caspase-activity

Fas has originally been described as a member of the death-receptor family, mediating apoptosis upon stimulation by Fas-ligand (FasL). However, Fas expressing human endometrial stromal cells (ESCs) are resistant to Fas-mediated apoptosis. Since the implanting embryo secretes FasL, we examined whether Fas mediates non-apoptotic effects in human ESCs in vitro. ESCs were isolated from hysterectomy specimens, decidualized using progesterone and 17β-estradiol and incubated with an activating anti-Fas antibody, recombinant FasL and a caspase-inhibitor. Leukemia inhibitory factor (LIF), interleukin (IL)-11, -6, -8, monocyte chemoattractant protein (MCP)-1 and RANTES (Regulated on Activation Normal T cell Expressed and Secreted) were measured using ELISA and real-time RT-PCR. Viability of ESCs was determined using an MTT assay. Caspase-activity was measured by luminescent assays. Activation of nuclear factor (NF)-κB was detected by in-cell western and transcription factor assays. LIF and IL-11 in undifferentiated and IL-8 in decidualized ESCs were up-regulated by non-apoptotic Fas-signaling. In contrast, IL-6, MCP-1 and RANTES were not regulated by Fas. Caspases were activated upon Fas-stimulation and the Fas-mediated effects on LIF, IL-11 and -8 were reversed by caspase-inhibition. The transcription factor NF-κB was not activated in ESCs after stimulation of Fas. These results suggest a differential regulatory role of caspase-dependent Fas-signaling at the feto-maternal interface during early implantation. Remarkably, this typical death machinery mediates non-apoptotic effects in the human endometrium rather than inducing apoptosis.

Constitutive activity of Erk1/2 and NF-κB protects human endometrial stromal cells from death receptor-mediated apoptosis

Apoptosis in the human endometrium plays an essential role for endometrial receptivity and early implantation. A dysbalance of pro- and anti-apoptotic events in the secretory endometrium seems to be involved in implantation disorders and consecutive pregnancy complications. However, little is known about the mechanisms regulating apoptosis-sensitivity in the human endometrium. Therefore this study was performed to identify molecular mechanisms underlying the resistance toward apoptosis in human endometrial stromal cells (ESCs). Human ESCs were isolated from hysterectomy specimens and used as undifferentiated cells or after decidualization in vitro. Cells were incubated with an activating anti-Fas antibody, tumor-necrosis factor (TNF)-related apoptosis-inducing ligand (TRAIL), TNF-α and inhibitors of protein- and RNA-syntheses, a caspase-inhibitor and inhibitors of extracellular signal regulated kinase (Erk)1/2, nuclear factor (NF)-κB and Akt. Apoptosis was measured by flow cytometric detection of hypodiploid nuclei. Caspase-activity was detected by luminescencent assays. Several pro- and anti-apoptotic molecules and the activation of Erk1/2, NF-κB and Akt were analyzed by in-cell Western assays or flow cytometry. Inhibition of protein- and RNA-syntheses differentially sensitized human ESCs for death receptor-mediated apoptosis in a caspase-dependent manner, based on the up-regulation of the death receptors Fas and TRAIL-R2. The constitutive activity of Erk1/2 and NF-κB could be identified as a reason for the apoptosis-resistance of human ESCs. These results suggest the pro-survival signaling pathways Erk1/2 and NF-κB as key regulators of the sensitivity of human ESCs for death receptor-mediated apoptosis. The modulation of these pathways might play an important role in the physiology of implantation.

The molecular charge and size of heparins determine their impact on the decidualization of human endometrial stromal cells.

Heparin modulates the decidualization of human endometrial stromal cells (ESCs), but the molecular mechanisms behind these effects are still unknown. In the present study, we further specified this biological effect of heparin in human ESCs in vitro. ESCs were isolated from hysterectomy specimens, decidualized over 12 days using progesterone and 17β-estradiol and incubated with thrombin, factor Xa (FXa), unfractionated heparin, dextran sulfate, danaparoid or different low-molecular-weight heparins (LMWHs). Production of insulin-like growth factor (IGF)-I, prolactin (PRL) and IGF-binding protein (IGFBP)-1 by ESCs was measured using ELISAs. Like heparin, thrombin and FXa cause an increase in IGF-I in ESCs, suggesting an action of heparin independent from its anticoagulatory effects. This was supported by demonstrating the induction of the same effects on IGF-I, PRL and IGFBP-1 as heparin by dextran sulfate, a polysaccharide of similar size and charge as heparin, but without anticoagulatory properties. LMWHs with the same anti-FXa activity as heparin showed less pronounced effects on ESCs than heparin, whereas the very short pentasaccharide fondaparinux (17 kDa) had barely any effect, further supporting the primary role of molecular size and charge mediating these biological effects of heparin on ESCs. In conclusion, the effects of heparin on the decidualization of human ESCs seem to be independent of its anticoagulatory function, but rather depend on the charge and the size of this polysulfated glycosaminoglycan. Therefore, highly sulfated polysaccharides with a molecular weight >17 kDa might be an interesting pharmacological approach for the therapy of endometrial pathologies, e.g. the treatment of women suffering from recurrent miscarriage or repeated implantation failure.

Heparin inhibits interferon-γ signaling in human endometrial stromal cells by interference with the cellular binding of interferon-γ

OBJECTIVE To examine the impact of heparins on interferon-γ (IFN-γ) signaling in human endometrial stromal cells (ESCs) in vitro. DESIGN In vitro experiment. SETTING Research laboratory at a medical university center. PATIENT(S) Premenopausal women undergoing hysterectomy for benign reasons. INTERVENTION(S) The ESCs were isolated from hysterectomy specimens, decidualized in vitro using P and 17β-E(2), and incubated with recombinant IFN-γ, unfractionated heparin, and low molecular weight heparins (LMWHs). MAIN OUTCOME MEASURE(S) Interferon response factor 1 (IRF-1) and N-myc interactor (Nmi) messenger RNA (mRNA) were measured using real-time reverse transcriptase-polymerase chain reaction (RT-PCR). Phosphorylation of signal transducer and activator of transcription 1 (STAT-1) was detected by an in-cell Western assay, expression of the IFN-γ receptor by flow cytometry. Cell-bound IFN-γ was determined in lysates by an ELISA. RESULT(S) Heparin and LMWHs inhibit the IFN-γ-mediated induction of IRF-1, but not Nmi in undifferentiated and decidualized ESCs. The phosphorylation of signal transducer and activator of transcription 1 STAT-1 upon IFN-γ stimulation is inhibited as well. Heparin has no effect on the IFN-γ receptor in ESCs, but inhibits the binding of IFN-γ to the cells. CONCLUSION(S) Unfractionated heparin, as well as LMWHs, are able to inhibit IFN-γ signaling in human ESCs and therefore might be clinically interesting agents to modulate the actions of this proinflammatory cytokine at the implantation site.

The role of recent thymic emigrant-regulatory T-cell (RTE-Treg) differentiation during pregnancy

During pregnancy, regulatory T cells (Tregs) have a key role in maternal immune tolerance to the semi‐allogeneic fetus. Our previous results showed that the naive CD45RA+‐Treg pool is functionally improved in pregnant women compared with non‐pregnant women. Therefore, we examined the thymic output and differentiation of CD45RA+CD31+ recent thymic emigrant (RTE)‐Tregs during normal pregnancy and in the presence of preeclampsia. With the onset of pregnancy, the composition of the total CD4+CD127low+/−FoxP3+‐Treg pool changed in the way that its percentage of RTE‐ and CD45RA−CD31+‐memory Tregs decreased strongly, whereas that of the CD45RA+CD31−‐mature naive (MN)‐Tregs did not change and that of the CD45RA−CD31−‐memory Tregs increased complementary. Thereby, the ratio of RTE‐/MN‐Tregs decreased from 1.0 to 0.7 leading to a significant increase in the suppressive activity of the naive CD45RA+‐Treg pool. This effect was confirmed by re‐assembling separated RTE‐ and MN‐Tregs from non‐pregnant women in the ratio of pregnant women. The suppressive activity of both separated naive Treg subsets was equally high in non‐pregnant and pregnant women, but considerably reduced in preeclampsia patients, who showed significantly increased percentages of CD45RA−CD31+‐memory Tregs, but decreased percentages of RTE‐ and MN‐Tregs. Our results suggest a reduced thymic output of RTE‐Tregs during pregnancy, which causes a decrease in the ratio of RTE‐/MN‐Tregs and thus an increase in the differentiation of RTE‐Tregs towards CD45RA−CD31−‐memory Tregs. Presumably, this differentiation of RTE‐Tregs, which was impaired in preeclampsia patients, ensures the improved suppressive activity of the CD45RA+‐naive Treg pool and thus retains the maintenance of pregnancy.

Plazentationsstörungen und fetale Wachstumsretardierung

Plazenta-induzierter Schwangerschaftserkrankungen (z.B. intrauterine Wachstumsretardierung, Praeklampsie und vorzeitige Plazentalosung) werden durch eine fehlerhafte Plazentation ausgelost. Eine biochemische Moglichkeit zur Differentialdiagnose kann die Bestimmung des sFlt-1/PlGF-Quotienten darstellen. Durch eine fetale Wachstumsretardierung kann es zu Hypoxamie und intrauterinem Fruchttod kommen. Zur Diagnosestellung wird u.a. die Dopplersonografie verwendet.