Mouse uterine stem cells are affected by endocrine disruption and initiate uteropathies

in Reproduction
Authors:
Pushpa SinghStem Cell Biology Department, ICMR-National Institute for Research in Reproductive & Child Health, Parel, Mumbai, India

Search for other papers by Pushpa Singh in
Current site
Google Scholar
PubMed
Close
https://orcid.org/0000-0001-5081-1694
and
Deepa BhartiyaStem Cell Biology Department, ICMR-National Institute for Research in Reproductive & Child Health, Parel, Mumbai, India

Search for other papers by Deepa Bhartiya in
Current site
Google Scholar
PubMed
Close
https://orcid.org/0000-0002-5384-3998
View More View Less

Correspondence should be addressed to D Bhartiya; Email: deepa.bhartiya@epigeneres.com

*(D Bhartiya is now at Epigeneres Biotech Pvt Ltd, Mumbai, India)

Restricted access

USD  $0.01
USD  $0.01

USD  $0.01
USD  $0.01

USD  $1.00
USD  $1.00

USD  $0.01
USD  $0.01

USD  $0.01
USD  $0.01

USD  $0.01
USD  $0.01

USD  $0.01
USD  $0.01

USD  $0.01
USD  $0.01

USD  $1.00
USD  $1.00

USD  $1.00
USD  $1.00

In brief

Incidence of uteropathies has increased in recent times, possibly due to exposure to endocrine-disrupting chemicals during early development. The present study shows that various uteropathies like endometrial cancer, adenomyosis, and endometriosis are interlinked and occur due to the dysfunction of tissue-resident, very small embryonic-like stem cells (VSELs).

Abstract

Underlying pathomechanisms leading to the initiation of uteropathies including non-receptive endometrium, hyperplasia, adenomyosis, endometriosis, fibroids, and cancer remain elusive. Two populations of stem cells exist in mouse uterus including pluripotent VSELs and ‘progenitors’ termed endometrial stem cells (EnSCs) which express ERα, ERβ, PR, and FSHR, participate in the regular remodelling, and maintain life-long homeostasis. The present study aimed to delineate possible stem cell origins for various uteropathies. For this, mouse pups were treated with oestradiol or diethylstilbestrol and were studied for adult onset of various uteropathies. Treatment resulted in disrupted oestrous cycles, reduced uterine weights, and marked hyperplasia in both epithelial and myometrial compartments, and the stromal compartment was also affected. VSELs were increased in numbers as judged by flow cytometry and increased expression of transcripts specific for Oct-4A, Sox-2, and Nanog, but their further differentiation into a receptive endometrium was affected. Reduced 5-methyl cytosine expression suggested global hypomethylation and was associated with several oncogenic events including loss of tumour-suppressor genes (Pten, p53), dysregulated DNA mismatch repair axis, and repair enzymes. Stem cells were epigenetically altered and showed increased expression of DNMTs, loss of imprinting loci (Igf2-H19, Dlk1-Meg3), and Ezh2. Increased co-expression of CD166 and ALDHA1 with OCT-4 in stem cells was associated with increased Esr-2 and reduced Pr in the endometrium, while both were several folds upregulated in the myometrium. Study results suggest that various uteropathies ensue due to the dysfunction of tissue-resident stem cells and provide huge scope for further research.

Supplementary Materials

 

  • Collapse
  • Expand
  • Afify SM & Seno M 2019 Conversion of stem cells to cancer stem cells: undercurrent of cancer initiation. Cancers 11 345. (https://doi.org/10.3390/cancers11030345)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Alamoudi MO 2021 The effect of endocrine disruptors on endometrial cells: a Systematic Review. Journal of Medical Science and Clinical Research 9. (https://doi.org/10.18535/jmscr/v9i2.29)

    • Search Google Scholar
    • Export Citation
  • Alavian-Ghavanini A & Rüegg J 2018 Understanding epigenetic effects of endocrine disrupting chemicals: from mechanisms to novel test methods. Basic and Clinical Pharmacology and Toxicology 122 3845. (https://doi.org/10.1111/bcpt.12878)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Al-Lamee H, Ellison A, Drury J, Hill CJ, Drakeley AJ, Hapangama DK & Tempest N 2022 Altered endometrial oestrogen-responsiveness and recurrent reproductive failure. Reproduction and Fertility 3 3038. (https://doi.org/10.1530/RAF-21-0093)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Bariani MV, Rangaswamy R, Siblini H, Yang Q, Al-Hendy A & Zota AR 2020 The role of endocrine-disrupting chemicals in uterine fibroid pathogenesis. Current Opinion in Endocrinology, Diabetes, and Obesity 27 380387. (https://doi.org/10.1097/MED.0000000000000578)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Batlle E & Clevers H 2017 Cancer stem cells revisited. Nature Medicine 23 11241134. (https://doi.org/10.1038/nm.4409)

  • Bhartiya D & James K 2017 Very small embryonic-like stem cells (VSELs) in adult mouse uterine perimetrium and myometrium. Journal of Ovarian Research 10 29. (https://doi.org/10.1186/s13048-017-0324-5)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Bhartiya D, Patel H, Ganguly R, Shaikh A, Shukla Y, Sharma D & Singh P 2018 Novel insights into adult and cancer stem cell biology. Stem Cells and Development 27 15271539. (https://doi.org/10.1089/scd.2018.0118)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Brehm E & Flaws JA 2019 Transgenerational effects of endocrine-disrupting chemicals on male and female reproduction. Endocrinology 160 14211435. (https://doi.org/10.1210/en.2019-00034)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Bruner-Tran KL, Gnecco J, Ding T, Glore DR, Pensabene V & Osteen KG 2017 Exposure to the environmental endocrine disruptor TCDD and human reproductive dysfunction: translating lessons from murine models. Reproductive Toxicology 68 5971. (https://doi.org/10.1016/j.reprotox.2016.07.007)

    • Search Google Scholar
    • Export Citation
  • Bulun SE, Monsavais D, Pavone ME, Dyson M, Xue Q, Attar E, Tokunaga H & Su EJ 2012 Role of estrogen receptor-β in endometriosis. Seminars in Reproductive Medicine 30 3945. (https://doi.org/10.1055/s-0031-1299596)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Chai S, Ng KY, Tong M, Lau EY, Lee TK, Chan KW, Yuan YF, Cheung TT, Cheung ST & Wang XQ et al.2016 Octamer 4/microRNA-1246 signaling axis drives Wnt/β-catenin activation in liver cancer stem cells. Hepatology 64 20622076. (https://doi.org/10.1002/hep.28821)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Chapman JC, Min SH, Freeh SM & Michael SD 2009 The estrogen-injected female mouse: new insight into the etiology of PCOS. Reproductive Biology and Endocrinology: RB&E 7 47. (https://doi.org/10.1186/1477-7827-7-47)

    • Search Google Scholar
    • Export Citation
  • Choi HY, Seok J, Kang GH, Lim KM & Cho SG 2021 The role of NUMB/NUMB isoforms in cancer stem cells. BMB Reports 54 335343. (https://doi.org/10.5483/BMBRep.2021.54.7.048)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Cousins FL, Filby CE & Gargett CE 2022 Endometrial stem/progenitor cells–their role in endometrial repair and regeneration. Frontiers in Reproductive Health 3. (https://doi.org/10.1007/s11154-012-9221-9)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Cousins FL, O DF & Gargett CE 2018 Endometrial stem/progenitor cells and their role in the pathogenesis of endometriosis. Best Practice and Research. Clinical Obstetrics and Gynaecology 50 2738. (https://doi.org/10.1016/j.bpobgyn.2018.01.011)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Daikoku T, Cha J, Sun X, Tranguch S, Xie H, Fujita T, Hirota Y, Lydon J, DeMayo F & Maxson R et al.2011 Conditional deletion of MSX homeobox genes in the uterus inhibits blastocyst implantation by altering uterine receptivity. Developmental Cell 21 10141025. (https://doi.org/10.1016/j.devcel.2011.09.010)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • de Graaff AA, Delvoux B, van de Vijver KK, Kyama CM, D’Hooghe TM, Dunselman GAJ & Romano A 2012 Paired-box gene 2 is down-regulated in endometriosis and correlates with low epidermal growth factor receptor expression. Human Reproduction 27 16761684. (https://doi.org/10.1093/humrep/des124)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • de Sousa E Melo F & Vermeulen L 2016 Wnt signaling in cancer stem cell biology. Cancers 8 60. (https://doi.org/10.3390/cancers8070060)

  • del Pup L, Mantovani A, Cavaliere C, Facchini G, Luce A, Sperlongano P, Caraglia M & Berretta M 2016 Carcinogenetic mechanisms of endocrine disruptors in female cancers (Review). Oncology Reports 36 603612. (https://doi.org/10.3892/or.2016.4886)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Devis L, Moiola CP, Masia N, Martinez-Garcia E, Santacana M, Stirbat TV, Brochard-Wyart F, García Á, Alameda F & Cabrera S et al.2017 Activated leukocyte cell adhesion molecule (ALCAM) is a marker of recurrence and promotes cell migration, invasion, and metastasis in early-stage endometrioid endometrial cancer. Journal of Pathology 241 475487. (https://doi.org/10.1002/path.4851)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Dunlap KA, Filant J, Hayashi K, Rucker EB, Song G, Deng JM, Behringer RR, DeMayo FJ, Lydon J & Jeong JW et al.2011 Postnatal deletion of Wnt7a inhibits uterine gland morphogenesis and compromises adult fertility in mice. Biology of Reproduction 85 386396. (https://doi.org/10.1095/biolreprod.111.091769)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Gerkowicz SA, Curtis SW, Knight AK, Cobb DO, Spencer JB, Conneely KN, Terrell ML, Marcus M & Smith AK 2020 Endometriosis, endocrine disrupters, and epigenetics: an investigation into the complex interplay in women with polybrominated biphenyl exposure and endometriosis. Journal of Assisted Reproduction and Genetics 37 427436. (https://doi.org/10.1007/s10815-020-01695-9)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Gibson DA & Saunders PTK 2014 Endocrine disruption of oestrogen action and female reproductive tract cancers. Endocrine-Related Cancer 21 T13T31. (https://doi.org/10.1530/ERC-13-0342)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Gunjal P, Bhartiya D, Metkari S, Manjramkar D & Patel H 2015 Very small embryonic-like stem cells are the elusive mouse endometrial stem cells- a pilot study. Journal of Ovarian Research 8 9. (https://doi.org/10.1186/s13048-015-0138-2)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Havens AM, Sun H, Shiozawa Y, Jung Y, Wang J, Mishra A, Jiang Y, O’Neill DW, Krebsbach PH & Rodgerson DO et al.2014 Human and murine very small embryonic-like cells represent multipotent tissue progenitors, in vitro and in vivo. Stem Cells and Development 23 689701. (https://doi.org/10.1089/scd.2013.0362)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hendry WJ, Hariri HY, Alwis ID, Gunewardena SS & Hendry IR 2014 Altered gene expression patterns during the initiation and promotion stages of neonatally diethylstilbestrol-induced hyperplasia/dysplasia/neoplasia in the hamster uterus. Reproductive Toxicology 50 6886. (https://doi.org/10.1016/j.reprotox.2014.09.002)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Hirao-Suzuki M 2021 Estrogen receptor β as a possible double-edged sword molecule in breast cancer: a mechanism of alteration of its role by exposure to endocrine-disrupting chemicals. Biological and Pharmaceutical Bulletin 44 15941597. (https://doi.org/10.1248/bpb.b21-00468)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • James K, Bhartiya D, Ganguly R, Kaushik A, Gala K, Singh P & Metkari SM 2018 Gonadotropin and steroid hormones regulate pluripotent very small embryonic-like stem cells in adult mouse uterine endometrium. Journal of Ovarian Research 11 83. (https://doi.org/10.1186/s13048-018-0454-4)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kamrani S, Amirchaghmaghi E, Ghaffari F, Shahhoseini M & Ghaedi K 2022 Altered gene expression of VEGF, IGFs and H19 lncRNA and epigenetic profile of H19-DMR region in endometrial tissues of women with endometriosis. Reproductive Health 19 100. (https://doi.org/10.1186/s12978-022-01406-w)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kaushik A, Anand S & Bhartiya D 2020 Altered biology of testicular VSELs and SSCs by neonatal endocrine disruption results in defective spermatogenesis, reduced fertility and tumor initiation in adult mice. Stem Cell Reviews and Reports 16 893908. (https://doi.org/10.1007/s12015-020-09996-3)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kaushik A & Bhartiya D 2020 Additional evidence to establish existence of two stem cell populations including VSELs and SSCs in adult mouse testes. Stem Cell Reviews and Reports 16 9921004. (https://doi.org/10.1007/s12015-020-09993-6)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kim DK, Ham MH, Lee SY, Shin MJ, Kim YE, Song P, Suh DS & Kim JH 2020 CD166 promotes the cancer stem-like properties of primary epithelial ovarian cancer cells. BMB Reports 53 622627. (https://doi.org/10.5483/BMBRep.2020.53.12.102)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Korucuoglu U, Biri AA, Konac E, Alp E, Onen IH, Ilhan MN, Turkyilmaz E, Erdem A, Erdem M & Menevse S 2010 Expression of the imprinted IGF2 and H19 genes in the endometrium of cases with unexplained infertility. European Journal of Obstetrics, Gynecology, and Reproductive Biology 149 7781. (https://doi.org/10.1016/j.ejogrb.2009.12.007)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Kucia M, Reca R, Campbell FR, Zuba-Surma E, Majka M, Ratajczak J & Ratajczak MZ 2006 A population of very small embryonic-like (VSEL) CXCR4+SSEA-1+Oct-4+ stem cells identified in adult bone marrow. Leukemia 20 857869. (https://doi.org/10.1038/sj.leu.2404171)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Lapinska K, Faria G, McGonagle S, Macumber KM, Heerboth S & Sarkar S 2018 Cancer progenitor cells: the result of an epigenetic event? Anticancer Research 38 16. (https://doi.org/10.21873/anticanres.12184)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Liang S, Huang C, Jia S & Wang B 2011 Activated leukocyte cell adhesion molecule expression is up-regulated in the development of endometrioid carcinoma. International Journal of Gynecological Cancer 21 523528. (https://doi.org/10.1097/IGC.0b013e31820e135a)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • MacLean JA & Hayashi K 2022 Progesterone actions and resistance in gynecological disorders. Cells 11 647. (https://doi.org/10.3390/cells11040647)

  • Martinez-Cruzado L, Tornin J, Santos L, Rodriguez A & Rodriguez R 2016 ALDH1 expression and activity increase during tumor evolution in sarcoma cancer stem cell populations. European Journal of Cancer 6 27878. (https://doi.org/10.1038/srep27878)

    • Search Google Scholar
    • Export Citation
  • Maruyama T 2022 A revised stem cell theory for the pathogenesis of endometriosis. Journal of Personalized Medicine 12 216. (https://doi.org/10.3390/jpm12020216)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Montgomery GW, Mortlock S & Giudice LC 2020 Should genetics now be considered the pre-eminent etiologic factor in endometriosis? Journal of Minimally Invasive Gynecology 27 280286. (https://doi.org/10.1016/j.jmig.2019.10.020)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Mortlock S, McKinnon B & Montgomery GW 2021 Genetic regulation of transcription in the endometrium in health and disease. Frontiers in Reproductive Health 3 795464. (https://doi.org/10.3389/frph.2021.795464)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Murphy AR, Campo H & Kim JJ 2022 Strategies for modelling endometrial diseases. Nature Reviews. Endocrinology 18 727743. (https://doi.org/10.1038/s41574-022-00725-z)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Newbold RR, Padilla-Banks E & Jefferson WN 2006 Adverse effects of the model environmental estrogen diethylstilbestrol are transmitted to subsequent generations. Endocrinology 147(Supplement) S11S17. (https://doi.org/10.1210/en.2005-1164)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Omar M, Laknaur A, Al-Hendy A & Yang Q 2019 Myometrial progesterone hyper-responsiveness associated with increased risk of human uterine fibroids. BMC Women’s Health 19 92. (https://doi.org/10.1186/s12905-019-0795-1)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Onuzulu CD, Rotimi OA & Rotimi SO 2019 Epigenetic modifications associated with in utero exposure to endocrine disrupting chemicals BPA, DDT and Pb. Reviews on Environmental Health 34 309325. (https://doi.org/10.1515/reveh-2018-0059)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Pacaud R, Brocard E, Lalier L, Hervouet E, Vallette FM & Cartron PF 2014 The DNMT1/PCNA/UHRF1 disruption induces tumorigenesis characterized by similar genetic and epigenetic signatures. Scientific Reports 4 4230. (https://doi.org/10.1038/srep04230)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Prusinski Fernung LE, Yang Q, Sakamuro D, Kumari A, Mas A & Al-Hendy A 2018 Endocrine disruptor exposure during development increases incidence of uterine fibroids by altering DNA repair in myometrial stem cells. Biology of Reproduction 99 735748. (https://doi.org/10.1093/biolre/ioy097)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Rainho CA, Pontes A & Rogatto SR 1999 Expression and imprinting of insulin-like growth factor II (IGF2) and H19 genes in uterine leiomyomas. Gynecologic Oncology 74 375380. (https://doi.org/10.1006/gyno.1999.5483)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Ratajczak MZ, Ratajczak J & Kucia M 2019 Very small embryonic-like stem cells (VSELs). Circulation Research 124 208210. (https://doi.org/10.1161/CIRCRESAHA.118.314287)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Ratajczak MZ, Zuba-Surma E, Wojakowski W, Suszynska M, Mierzejewska K, Liu R, Ratajczak J, Shin DM & Kucia M 2014 Very small embryonic-like stem cells (VSELs) represent a real challenge in stem cell biology: recent pros and cons in the midst of a lively debate. Leukemia 28 473484. (https://doi.org/10.1038/leu.2013.255)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Rumph JT, Stephens VR, Archibong AE, Osteen KG & Bruner-Tran KL 2020 Environmental endocrine disruptors and endometriosis. Advances in Anatomy, Embryology, and Cell Biology 232 5778.

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Salamonsen LA, Hutchison JC & Gargett CE 2021 Cyclical endometrial repair and regeneration. Development 148. (https://doi.org/10.1242/dev.199577)

  • Sarno L 2019 Endometrial carcinoma and bisphenol A: a pilot case-control study. Biomedical Journal of Scientific and Technical Research 21. (https://doi.org/10.26717/BJSTR.2019.21.003641)

    • Search Google Scholar
    • Export Citation
  • Sato K, Fukata H, Kogo Y, Ohgane J, Shiota K & Mori C 2009 Neonatal exposure to diethylstilbestrol alters expression of DNA methyltransferases and methylation of genomic DNA in the mouse uterus. Endocrine Journal 56 131139. (https://doi.org/10.1507/endocrj.k08e-239)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Shaikh A, Anand S, Kapoor S, Ganguly R & Bhartiya D 2017 Mouse Bone Marrow VSELs Exhibit Differentiation into three embryonic Germ Lineages and Germ & hematopoietic Cells in Culture. Stem Cell Reviews and Reports 13 202216. (https://doi.org/10.1007/s12015-016-9714-0)

    • Search Google Scholar
    • Export Citation
  • Sharma D & Bhartiya D 2021 Stem cells in adult mice ovaries form germ cell nests, undergo meiosis, neo-oogenesis and follicle assembly on regular basis during estrus cycle. Stem Cell Reviews and Reports 17 16951711. (https://doi.org/10.1007/s12015-021-10237-4)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Sharma D & Bhartiya D 2022 Dysfunctional ovarian stem cells due to neonatal endocrine disruption result in PCOS and ovarian insufficiency in adult mice. Stem Cell Reviews and Reports 18 29122927. (https://doi.org/10.1007/s12015-022-10414-z)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Singh P & Bhartiya D 2021 Pluripotent stem (VSELs) and progenitor (EnSCs) cells exist in adult mouse uterus and show cyclic changes across estrus cycle. Reproductive Sciences 28 278290. (https://doi.org/10.1007/s43032-020-00250-2)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Singh P & Bhartiya D 2022 Molecular insights into endometrial cancer in mice. Stem Cell Reviews and Reports 18 17021717. (https://doi.org/10.1007/s12015-022-10367-3)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Singh P, Metkari S & Bhartiya D 2022a Additional evidence to support OCT-4 positive VSELs and EnSCs as the elusive tissue-resident stem/progenitor cells in adult mice uterus. Stem Cell Research and Therapy 13 60. (https://doi.org/10.1186/s13287-022-02703-8)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Singh P, Metkari SM & Bhartiya D 2022b Mice Uterine Stem Cells are Affected by Neonatal Endocrine Disruption & Initiate Uteropathies in Adult Life Independent of Circulatory Ovarian Hormones. Stem Cell Reviews and Reports 18 16861701. (https://doi.org/10.1007/s12015-021-10279-8)

    • Search Google Scholar
    • Export Citation
  • Skakkebæk NE, Lindahl-Jacobsen R, Levine H, Andersson AM, Jørgensen N, Main KM, Lidegaard Ø, Priskorn L, Holmboe SA & Bräuner EV et al.2022 Environmental factors in declining human fertility. Nature Reviews. Endocrinology 18 139157. (https://doi.org/10.1038/s41574-021-00598-8)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Suen AA, Jefferson WN, Williams CJ & Wood CE 2018 Differentiation patterns of uterine carcinomas and precursor lesions induced by neonatal estrogen exposure in mice. Toxicologic Pathology 46 574596. (https://doi.org/10.1177/0192623318779326)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Szukiewicz D, Stangret A, Ruiz-Ruiz C, Olivares EG, Soriţău O, Suşman S & Szewczyk G 2021 Estrogen- and progesterone (P4)-Mediated Epigenetic Modifications of Endometrial Stromal Cells (EnSCs) and/or Mesenchymal Stem/Stromal Cells (MSCs) in the Etiopathogenesis of Endometriosis. Stem Cell Reviews and Reports 17 11741193. (https://doi.org/10.1007/s12015-020-10115-5)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Takama F, Kanuma T, Wang D, Kagami I & Mizunuma H 2001 Oestrogen receptor β expression and depth of myometrial invasion in human endometrial cancer. British Journal of Cancer 84 545549. (https://doi.org/10.1054/bjoc.2000.1589)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tang W, Ramasamy K, Pillai SMA, Santhamma B, Konda S, Pitta Venkata P, Blankenship L, Liu J, Liu Z & Altwegg KA et al.2021 LIF/LIFR oncogenic signaling is a novel therapeutic target in endometrial cancer. Cell Death Discovery 7 216. (https://doi.org/10.1038/s41420-021-00603-z)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tanos V, Ariel I, Prus D, De-Groot N & Hochberg A 2004 H19 and IGF2 gene expression in human normal, hyperplastic, and malignant endometrium. International Journal of Gynecological Cancer 14 521525. (https://doi.org/10.1111/j.1048-891x.2004.014314.x)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Tomita H, Tanaka K, Tanaka T & Hara A 2016 Aldehyde dehydrogenase 1A1 in stem cells and cancer . Oncotarget 7 1101811032.

  • Wang KY, Chen CC, Tsai SF & Shen C-KJ 2016 Epigenetic enhancement of the post-replicative DNA mismatch repair of mammalian genomes by a Hemi-mCpG-Np95-Dnmt1 axis. Scientific Reports 6 37490. (https://doi.org/10.1038/srep37490)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Wen HJ, Chang TC, Ding WH, Tsai SF, Hsiung CA & Wang SL 2020 Exposure to endocrine disruptor alkylphenols and the occurrence of endometrial cancer. Environmental Pollution 267 115475. (https://doi.org/10.1016/j.envpol.2020.115475)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Yang L, Shi P, Zhao G, Xu J, Peng W, Zhang J, Zhang G, Wang X, Dong Z & Chen F et al.2020 Targeting cancer stem cell pathways for cancer therapy. Signal Transduction and Targeted Therapy 5 8. (https://doi.org/10.1038/s41392-020-0110-5)

    • Search Google Scholar
    • Export Citation
  • Yilmaz E, Celik O, Simsek Y, Turkcuoglu I, Celik E, Gül M, Hascalik S & Aydin NE 2012 c-kit proto-oncogene expression in endometrial hyperplasia and endometrial cancer. Archives of Gynecology and Obstetrics 286 197200. (https://doi.org/10.1007/s00404-012-2276-8)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Zhang Q, Han Z, Zhu Y, Chen J & Li W 2020 The role and specific mechanism of OCT4 in cancer stem cells: a review. International Journal of Stem Cells 13 312325. (https://doi.org/10.15283/ijsc20097).

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Zhang Y, Lu Y, Ma H, Xu Q & Wu X 2021 Combined exposure to multiple endocrine disruptors and uterine leiomyomata and endometriosis in US women. Frontiers in Endocrinology 12 726876. (https://doi.org/10.3389/fendo.2021.726876)

    • PubMed
    • Search Google Scholar
    • Export Citation
  • Zubrzycka A, Zubrzycki M, Perdas E & Zubrzycka M 2020 Genetic, epigenetic, and steroidogenic modulation mechanisms in endometriosis. Journal of Clinical Medicine 9 1309. (https://doi.org/10.3390/jcm9051309)

    • PubMed
    • Search Google Scholar
    • Export Citation