The physiological mechanisms whereby the human endometrium avoids hemorrhage during trophoblastic vascular invasion, yet paradoxically permits menstrual-related vascular disruption, are unknown. Similarly, there is a paucity of information on the pathogenic mechanisms underlying abnormal uterine bleeding associated with adverse obstetrical outcomes, anovulation and contraceptive therapy. This fundamental conundrum in reproductive biology is addressed through our hypothesis that decidualized stromal cells contribute to endometrial hemostasis by increased expression of the potent procoagulant tissue factor (TF) in response to progestational stimulation during the luteal phase, and to menstruation via decreased TF expression in response to the withdrawal of progesterone at the end of the luteal phase. This hypothesis will be tested using stromal cells from cycling endometrium and decidual cells from first trimester pregnant endometrium to examine: l) the effects of progestins and progestin antagonists on the rates of synthesis and degradation of TF m-RNA and protein in stromal cell monolayers, and whether these effects involve mediation of intracrine or autocrine factors; 2) the influence exerted on progestin-regulated TF expression in the stromal cell monolayers by exogenous and endogenous growth factors already implicated in the decidualization reaction in women; 3) the role of cell- extracellular matrix (ECM) interactions in modulating progestin and growth factor regulated TF expression in stromal cells and decidual cells; and 4) the role of cell-cell interactions in modulating progestin, growth factor, and ECM-regulated TF expression in stromal cells and decidual cells in co- cultures of endometrial glandular cells-stromal cells and trophoblastic cells-decidual cells. The experimental results will aid in the dissection of mechanisms regulating TF expression associated with decidualization in vitro. Extrapolation of these results to the in vivo state should elucidate the importance of decidual cell-associated TF in peri- implantational events, and during menstruation. Once the physiological role of decidual cell TF is established new diagnostic and therapeutic approaches to deal with abnormal bleeding during these processes can be expected to follow.

Agency
National Institute of Health (NIH)
Institute
Eunice Kennedy Shriver National Institute of Child Health & Human Development (NICHD)
Type
First Independent Research Support & Transition (FIRST) Awards (R29)
Project #
1R29HD029540-01A1
Application #
3470579
Study Section
Human Embryology and Development Subcommittee 1 (HED)
Project Start
1993-09-01
Project End
1998-08-31
Budget Start
1993-09-01
Budget End
1994-08-31
Support Year
1
Fiscal Year
1993
Total Cost
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Type
Schools of Medicine
DUNS #
City
New York
State
NY
Country
United States
Zip Code
10029
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Lockwood, C J; Krikun, G; Hausknecht, V A et al. (1998) Matrix metalloproteinase and matrix metalloproteinase inhibitor expression in endometrial stromal cells during progestin-initiated decidualization and menstruation-related progestin withdrawal. Endocrinology 139:4607-13
Schatz, F; Papp, C; Aigner, S et al. (1997) Biological mechanisms underlying the clinical effects of RU 486: modulation of cultured endometrial stromal cell stromelysin-1 and prolactin expression. J Clin Endocrinol Metab 82:188-93
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Arcuri, F; Monder, C; Lockwood, C J et al. (1996) Expression of 11 beta-hydroxysteroid dehydrogenase during decidualization of human endometrial stromal cells. Endocrinology 137:595-600
Lockwood, C J; Schatz, F (1996) A biological model for the regulation of peri-implantational hemostasis and menstruation. J Soc Gynecol Investig 3:159-65
Schatz, F; Aigner, S; Papp, C et al. (1995) Plasminogen activator activity during decidualization of human endometrial stromal cells is regulated by plasminogen activator inhibitor 1. J Clin Endocrinol Metab 80:2504-10
Lockwood, C J; Krikun, G; Papp, C et al. (1994) Biological mechanisms underlying RU 486 clinical effects: inhibition of endometrial stromal cell tissue factor content. J Clin Endocrinol Metab 79:786-90