Kaiqing Lin

Reproductive outcome following resectoscope metroplasty in women having a complete uterine septum with double cervix and vagina

To evaluate reproductive outcomes in women with complete uterine septum with double cervix and vagina following resectoscope metroplasty.

Increased steroid receptor RNA activator protein (SRAP) accompanied by decreased estrogen receptor-beta (ER-β) levels during the malignant transformation of endometriosis associated ovarian clear cell carcinoma.

The modulating attributes of steroid receptor RNA activator protein (SRAP) on steroid receptors have been shown in some types of tumor cells. There is compelling evidence to suggest that this molecule may play a critical role in the development of the tumor. However, little has been reported on its expression in endometriosis associated ovarian clear cell carcinoma (EAOCCC). In order to investigate the role of SRAP and estrogen receptors (ERs) in EAOCCC, we have analyzed the distribution of these proteins in the malignant transformation tissues and endometrioma tissues by immunohistochemistry. Our results revealed that the positive ratio of ER-β expression was gradually reduced during the malignant transformation from endometriosis to atypical endometriosis to clear cell carcinoma. Conversely, during the process, a gradual increase in SRAP expression was observed. Furthermore, there is a negative relationship between the expressions of these two molecules. Overall an increase in SRAP and a reduction in ER-β expression might be associated with malignant transformation of EAOCCC.

A new fertility-preserving surgery for interstitial pregnancy involving hysteroscopic removal under laparoscopic guidance

Interstitial pregnancy is a rare form of tubal ectopic pregnancy, accounting for 2%–4% of all such pregnancies [1]. Although medical treatment can successfully resolve the pregnancy when detected early enough, the standard treatment is cornual resection [2]. However, surgical treatmentmay result in aweakened uterinewall, leading to reduced fertility and a risk of uterine rupture in subsequent pregnancies. Successful transcervical evacuation of interstitial pregnancy under laparoscopic guidance has been reported [2]. However, owing to the characteristics of interstitial pregnancy and potential difficulties encountered during surgery, the placenta may be left behind—necessitating further treatment [3]. Hysteroscopic removal, when possible, reduces the incidence rate of this complication. In 2013, a 26-year-old nulliparous woman presented with an interstitial pregnancy. She wanted to preserve an intact uterus, so hysteroscopic removal was carried out using a technique similar to that performed for intrauterine evacuation. Hegar dilators were used for dilation of the cervical canal and the ostium of the fallopian tube; the dilators were used to reach the uterine cornu and to carefully establish a passage to the gestational site under laparoscopic guidance. A 6-mm suction catheter was then inserted into the uterus and introduced into the gestational site. The products of conception were evacuated at a negative pressure of 180 mm Hg. The hysteroscope was then introduced into the interstitial cavity because a more dilated pathologic tubal ostium was observed. Graspers were used to remove residual tissue from the interstitial cavity, leaving it empty (Fig. 1). Had uterine perforation occurred, cornual resection and salpingectomy would have been performed via laparoscopy. Thewomanwas discharged 2 days later; her serum β-human chorionic gonadotropin levels were undetectable by the second postoperative week. Ultrasound examination 4 weeks postoperatively showed that the cornual region had a normal appearance. When there is a possibility of interstitial pregnancy that is a relatively short distance from the cornual end and is associated with an unruptured mass and hemodynamic stability, hysteroscopic removal under laparoscopic guidance—rather than cornual resection—is a feasible treatment option. Furthermore, this new treatment can prevent a large amount of blood loss; however, when there is a high risk of tubal scarring, recurrent interstitial pregnancy may occur.

Silencing of SRA1 Regulates ER Expression and Attenuates the Growth of Stromal Cells in Ovarian Endometriosis

Estradiol and its nuclear receptors, estrogen receptor (ER) α and ER-β, have important functions in endometriosis, and the transcriptional activity of these receptors is modulated by coactivators and corepressors. The steroid receptor RNA activator 1 (SRA1) produces SRA long noncoding RNA (lncRNA) and SRA protein (SRAP), which regulate ER expression at the RNA and protein levels in some hormone-dependent tumors via an alternative splicing event. However, only a few are reported on their expressions in endometriosis. Here, we observed that low expression levels of SRA lncRNA and ER-α but relatively high expression levels of SRAP and ER-β were detected in ovarian endometriotic tissues versus normal endometrial tissues. Steroid receptor RNA activator I-small interfering RNA treatment significantly increased ER-α levels but reduced ER-β levels in endometriotic stromal cells (ESCs). Furthermore, the treatment can also attenuate the proliferation and promote early apoptosis in these cells. Our results indicate that the regulation of ER via SRA in ovarian endometriosis may play a significant role in the growth of ESCs.Estradiol and its nuclear receptors, estrogen receptor (ER) α and ER-β, have important functions in endometriosis, and the transcriptional activity of these receptors is modulated by coactivators and corepressors. The steroid receptor RNA activator 1 (SRA1) produces SRA long noncoding RNA (lncRNA) and SRA protein (SRAP), which regulate ER expression at the RNA and protein levels in some hormone-dependent tumors via an alternative splicing event. However, only a few are reported on their expressions in endometriosis. Here, we observed that low expression levels of SRA lncRNA and ER-α but relatively high expression levels of SRAP and ER-β were detected in ovarian endometriotic tissues versus normal endometrial tissues. Steroid receptor RNA activator 1–small interfering RNA treatment significantly increased ER-α levels but reduced ER-β levels in endometriotic stromal cells (ESCs). Furthermore, the treatment can also attenuate the proliferation and promote early apoptosis in these cells. Our results indicate that the regulation of ER via SRA in ovarian endometriosis may play a significant role in the growth of ESCs.

Influence of ovarian endometrioma on expression of steroid receptor RNA activator, estrogen receptors, vascular endothelial growth factor, and thrombospondin 1 in the surrounding ovarian tissues.

This study investigates the influence of ovarian endometrioma on expression of steroid receptor RNA activator (SRA), estrogen receptors (ERs), vascular endothelial growth factor (VEGF), and thrombospondin 1 (TSP-1) in the surrounding ovarian tissues. Taken from the women with ovarian endometrioma and mature teratoma during laparoscopy, the biopsies were analyzed by real-time polymerase chain reaction and Western blot. Our results indicated that ovarian tissues surrounding endometrioma had lower SRA and ER-α levels but higher SRA protein (SRAP) and ER-β levels than ovarian endometrioma. With lower VEGF levels and higher TSP-1 levels, the surrounding ovarian tissues showed higher expression levels of SRA, SRAP, ER-α, and ER-β in the ovarian endometrioma group when compared to the controls. These data showed that ovarian endometrioma increases SRA, ERs, and TSP-1 but decreases VEGF levels in the surrounding ovarian tissues, suggesting that abnormal expression of these molecules may affect biological behaviors of ovarian endometrioma.

Analysis of long non-coding RNA expression profiles using RNA sequencing in ovarian endometriosis

Endometriosis is a common gynecological condition with unclear pathogenesis. Although a dysregulated lncRNA expression profile has been speculated, very few studies have addressed this hypothesis. We determined the differential lncRNA and mRNA expression patterns between endometriosis and control tissues, and between eutopic and normal endometrium in the proliferative phase, using RNA sequencing. The potential targets of lncRNA were predicted on the basis of cis and trans action, and lncRNAs were functionally annotated in relation to their co-expressed mRNAs. Dysregulated lncRNAs and mRNAs were screened relative to the biological features of endometriosis, and the five filtered lncRNAs were validated using qRT-PCR. A total of 9924 novel lncRNA transcripts were identified, and 86 lncRNAs and 1228 mRNAs were differentially expressed between the endometriosis and control groups. GO and KEGG pathway analysis showed that the differentially expressed lncRNAs were enriched in the biological processes and signaling pathways involved in endometriosis. A coding-noncoding gene (CNC) co-expression network was constructed using the dysregulated lncRNAs and their co-expressed mRNAs to simulate the complex intergenic interactions. This study is the first to use sequencing technology to elucidate the differentially lncRNA expression profiles of eutopic and normal endometrium in the proliferative phase of endometriosis. The dysregulated lncRNAs can potentially be novel diagnostic biomarkers and therapeutic targets of endometriosis.

Upregulation of S100A6 in patients with endometriosis and its role in ectopic endometrial stromal cells

Abstract S100 calcium-binding protein A6 (S100A6) is up-regulated in many malignancies and overexpression of S100A6 has been identified associated with proliferation, migration and invasion phenotype in several cancer cells. In the present study, we explored whether S100A6 plays a role in the development of endometriosis. Significantly higher levels of mRNA and protein expression of S100A6 were observed in ectopic endometrial tissues compared to eutopic and normal endometrial tissues. Silencing of S100A6 in ectopic endometrial stromal cells (ESCs) significantly inhibited cell viability, migration and invasion. Moreover, knockdown of S100A6 suppressed p38/MAPK activity in ectopic ESCs, which can be partially attenuated by CacyBP/SIP phosphorylation inhibitor. In conclusion, our results suggest that the abnormal expression of S100A6 may contribute to the pathogenesis of endometriosis and the S100A6/CacyBP/p38 signaling may provide as a promising treatment target.