Localization of Mucin 1 in endometrial luminal epithelium and its expression in women with reproductive failure during implantation window

Endometrial glands are necessary for conceptus implantation and growth. In the ovine uterine gland knockout (UGKO) model, blastocysts hatch normally but fail to survive or elongate. This peri-implantation defect in UGKO ewes may be due to the absence of endometrial glands or, alternatively, to the lack of certain epithelial adhesion molecules or the inability of the endometrium to respond to signals from the conceptus. Two studies were performed to examine these hypotheses. In study one, normal (n = 8) and UGKO (n = 12) ewes were mated at oestrus (day 0) with intact rams and their uteri were flushed 14 days after oestrus. Normal ewes (n = 4) were also flushed on 14 days after oestrus. Uterine flushes from bred normal ewes contained filamentous conceptuses (n = 7 of 8), whereas those from UGKO ewes contained no conceptus (n = 5 of 12), a growth-retarded, tubular conceptus (n = 6 of 12), or a fragmented, filamentous conceptus (n = 1 of 12). In all groups, expression of mucin 1 and integrin alpha(v), alpha(5), beta(3) and beta(5) was localized at the apical surface of the endometrial luminal epithelium with no detectable differences between normal and UGKO ewes. Uterine flushes from pregnant ewes, but not cyclic or UGKO ewes, contained abundant immunoreactive interferon tau and the cell adhesion proteins, osteopontin and glycosylation-dependent cell adhesion molecule one. In study two, UGKO ewes were fitted with uterine catheters 5 days after oestrus, infused with recombinant ovine interferon tau or control proteins from 11 to 15 days after oestrus, and underwent hysterectomy 16 days after oestrus. Expression of several interferon tau-stimulated genes (ISG17, STAT1, STAT2 and IRF-1) was increased in the endometrium from interferon tau-infused UGKO ewes. These results support the hypothesis that the defects in conceptus elongation and survival in UGKO ewes are due to the absence of endometrial glands and their secretions rather than to alterations in expression of anti-adhesive or adhesive molecules on the endometrial luminal epithelium or to the responsiveness of the endometrium to the conceptus pregnancy recognition signal.

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P–361 Endometrium optical coherence tomography (OCT) and histomorphometry in implantation window and their relationships with reproductive failure and implantation outcome

Human Reproduction ◽

10.1093/humrep/deab130.360 ◽

2021 ◽

Vol 36 (Supplement_1) ◽

Author(s):

R Zhang ◽

T S M Law ◽

B Liang ◽

S W Hung ◽

S Lin ◽

...

Keyword(s):

Stromal Cell ◽

Reproductive Failure ◽

Implantation Window ◽

Image Characteristics ◽

Unk Cells ◽

Natural Conception ◽

Oct Imaging ◽

Infertile Group ◽

Oct Image ◽

Uterine Fundus

Abstract Study question How do endometrium OCT image characteristics during peri-implantation window correlate with histomorphometry and associate with implantation outcomes in women with reproductive failure? Summary answer Endometrium OCT intensity correlated with stromal cell density and gland size. Endometrium with recurrent implantation failure had low OCT intensity but reversed in successful implantation. What is known already OCT is a non-invasive imaging technique using low energy near-infrared light to capture micrometer-scale resolution images from optical scattering media. An image produced by OCT resembles tissue architecture observed in histology, so OCT imaging has been regarded as “optical biopsy”. Our previous findings demonstrated OCT is better than ultrasound to identify endometrial pathology. We also showed association of OCT signal with microvessel density in peri-implantation endometrium. However, other histomorphometry were not evaluated. It is still unclear whether endometrium OCT image characteristics are different in reproductive failure and can predict implantation outcomes. Study design, size, duration This was a prospective study conducted at teaching hospital of The Chinese University of Hong Kong from Jan 2018 to Dec 2019. 46 infertile women with or without recurrent miscarriage (RM) and implantation failure (RIF) were recruited in this study. Endometrium OCT imaging and subsequent biopsy were performed on the seventh day after luteal hormone surge (LH + 7) in natural cycle prior to the consecutive natural conception or embryo transfer (ET) cycle. Participants/materials, setting, methods At least 5 systematic random endometrium OCT images from uterine fundus, body and lower segment of each subject were included for intensity analysis by two independent observers. OCT intensity of each image was classified as low, moderate, high based on optical range and then average OCT intensity in each uterine region was calculated for group comparison. Endometrium glandular epithelial, stromal, endothelial, uNK cells were defined by standard H&E and specific immunostaining for histomorphometry and correlation. Main results and the role of chance OCT intensity significantly correlated with endometrial cell and gland parameters regardless classifications of reproductive failure and implantation outcome. Higher OCT intensity indicated higher stromal cell density, gland to stromal (G/S) ratio and average gland area, but fewer microvessel and uNK cells. None of the endometrium histomorphometry were significantly different among different reproductive failure types and implantation outcomes, suggesting it may not be sensitive enough to detect the abnormal histological features. However, OCT intensity was significantly lower in the uterine fundus and body of RIF group than in that of infertile and RM groups. There was no significant difference of OCT intensity in the lower part of the endometrium among three groups. It indicates that OCT intensity is a sensitive marker to differentiate endometrium with RIF from the endometrium with other conditions and also endometrium with RIF is characterized with less stromal cells and smaller glands. Compared with infertile group with unsuccessful implantation, OCT intensity was higher in all three parts of the uterus from the infertile group with successful implantation, but the results were not statistically different. The results further implied that endometrial cells and gland size may potentially contribute to the endometrium receptivity for implantation. Limitations, reasons for caution Current endometrium OCT imaging depth is within 3mm, change beyond this thickness is inaccessible but still the most important layer for implantation. This is a pilot and small study with lack of normal fertile control. Endometrium OCT imaging in the same natural conception or ET cycle will be more accurate. Wider implications of the findings: OCT imaging could be used as a potential noninvasive modality to evaluate peri-implantation window endometrium. It enables real-time and in-situ visualization of endometrium structure and pathology with no additional biopsy risk and examination delay. Larger clinical trials are needed to confirm its clinical applications and utilities. Trial registration number CREC 2016.160

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Mucin1 (MUC1) localization and quantitative study in luminal epithelium during implantation window

10.26226/morressier.5af300b1738ab10027aa976f ◽

2018 ◽

Author(s):

Fangrong Wu

Keyword(s):

Quantitative Study ◽

Luminal Epithelium ◽

Implantation Window

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Vollwandresektion eines Pylorusdrüsenadenoms im proximalen Duodenum bei einem 67-jährigen Patienten mit attenuierter Polyposis coli

Zeitschrift für Gastroenterologie ◽

10.1055/a-1143-6640 ◽

2020 ◽

Vol 58 (08) ◽

pp. 767-772

Author(s):

Oliver Anliker ◽

Wolfram Sieweke ◽

Antonia Töpfer ◽

Ines Wülker ◽

Matthias Breidert

Keyword(s):

Polyposis Coli ◽

Mucin 1 ◽

Endoskopische Mukosaresektion ◽

Maligne Entartung ◽

Second Look ◽

Kolorektale Adenome ◽

Mib 1 ◽

Endoskopische Submukosadissektion

Zusammenfassung Einleitung Das Pylorusdrüsenadenom (PGA) ist eine unterdiagnostizierte, seltene Entität, die meist im Magen zu finden ist. Ähnlich wie kolorektale Adenome haben PGAs ein hohes Risiko für eine maligne Entartung zum Adenokarzinom von bis zu 12–47 %. Endoskopische Resektionen im Duodenum bergen ein erhebliches Risiko für Komplikationen. Die endoskopische Mukosaresektion (EMR) ist die derzeitige Standardtechnik zur Behandlung von duodenalen nichtampullären Adenomen. Die vollständigen Resektionsraten sind mit etwa 90 % beträchtlich hoch. Komplikationen wie Blutungen wurden bis zu 25 % verzeichnet. Die endoskopische Submukosadissektion (ESD) wird für die Resektion von Duodenalläsionen nicht empfohlen, da die Perforationsrate bis zu 35 % betragen kann. Die Anwendung der endoskopischen Vollwandresektion (EFTR) im Duodenum ist auf eine Fallstudie mit 20 Patienten beschränkt. Fall Ein 67-jähriger Patient mit attenuierter Polyposis coli (FAP) wurde zum Screening vorgestellt. Die Gastroskopie zeigte eine 20 mm große, nichtampulläre Läsion im proximalen Duodenum (Pars I). Die Ränder der Duodenalläsionen wurden mit einer Hochfrequenzsonde (HF) markiert. Eine integrierte Ballondilatation (20 mm) des oberen Ösophagussphinkters und des Pylorus erleichterte das Vorschieben des Device (FTRD®, Fa. Ovesco Endoscopy AG, Tübingen). Nachdem die Läsion mit einem Greifer in die Kappe gezogen worden war, erfolgte die Applikation der Bärenklaue, und die Läsion wurde anschließend mit der integrierten Schlinge reseziert. Eine einmalige Antibiotikaprophylaxe mit 2 g Ceftriaxon i. v. wurde während der Intervention verabreicht. Die Second-Look-Endoskopie erfolgte 24 Stunden nach der Resektion. Das Resektat zeigte eine PGA von 18 mm Größe im proximalen Duodenum (immunhistochemisch positiv für Mucin-1, Mucin-5, Mib 1). Zusammenfassung Hier präsentieren wir den ersten Fall einer duodenalen EFTR bei einem Patienten mit attenuierter FAP mit Erstbeschreibung eines Pylorusdrüsenadenoms. Derzeit gibt es keine spezifischen Richtlinien für die Entfernung und Überwachung. Die ASGE empfiehlt bei Pylorusdrüsenadenomen eine Resektions- und Überwachungsendoskopie im Abstand von 3–5 Jahren.

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