The Effect of Imbalanced Progesterone Receptor-A/-B Ratio on Gelatinase Expressions in Endometriosis.

Background: Gelatinases degrade extracellular matrix (ECM) components to allow for physiological remodeling and contribute to pathological tissue destruction in endometriosis. It is known that the function of gelatinases is resistant to suppression by progesterone in endometriosis. The ability of progesterone to impact gene expression depends on the ratio. An imbalanced ratio in endometriotic tissue may be the result of the differential expression of and , which could be important in the etiology and pathogenesis of the disease. Hence, we decided to study the association of ratio and gelatinases expression in endometriosis.

Materials And Methods: In this prospective case-control study, we enrolled 40 women, 20 in the case group who were diagnosed with stage III/IV endometriosis and 20 normal subjects without endometriosis (controls) who referred to Royan Institute, Tehran, Iran during 2013-2014. We obtained 60 tissue samples [ectopic (n=20), eutopic (n=20), and normal endometrium (n=20)]. RNA was extracted from the tissue samples in order to analyze , , , and mRNA levels through real-time polymerase chain reaction (PCR).

Results: There was significantly lower expression of the isoform in ectopic tissues compared to the control (P=0.002) and eutopic endometrium (P=0.006) tissues. PR-A expression was higher, but not significantly so, in the same ectopic and eutopic endometrium tissues compared to the control tissues (P=0.643). There was significant overexpression of in ectopic samples compared to control (P=0.014) and eutopic endometrium (P=0.012) samples. The ratio was not significantly higher in either eutopic or ectopic samples compared to the control samples (P=0.305).

Conclusion: Our findings support an altered expression in endometriosis, which may be associated with overexpression. This finding can be important for disease pathogenesis.