Altered Endometrial Expression of alpha-Inhibin Subunit and Its Co-Receptor Betaglycan in Infertile Women with Endometriosis

Background: Inhibins and their co-receptor betaglycan are members of the transforming growth factor beta superfamily, a group of signaling molecules that control the differentiation of human endometrium in the secretory phase of the menstrual cycle. Objective: Since endometriosis is associated with endometrial dysfunction and infertility, this study aimed at evaluating the expression of alpha-inhibin and betaglycan mRNA and proteins in endometrial samples of infertile women with and without endometriosis. Design: This was a cross-sectional study. Participants/Materials: Endometrial samples of women with (n = 17) and without (n = 22) endometriosis were subdivided according to the menstrual cycle phase into proliferative and secretory. Setting: University hospital. Methods: We used real-time RT-PCR to quantify mRNA levels and immunohistochemistry to localize the proteins. Results: alpha-inhibin mRNA levels were significantly increased in the secretory phase (p < 0.01 vs. proliferative phase) only among women with endometriosis. Conversely, betaglycan mRNA levels were downregulated in the secretory endometrium of controls (p < 0.01 vs. proliferative) but failed to change between cycle phases of patients with endometriosis. Both proteins were present in the glandular epithelium and stroma in the endometrium of women with and without endometriosis. Immunostaining analysis showed that while alpha-inhibin protein expression did not vary significantly, the intensity of betaglycan immunostaining decreased in the secretory phase in the control group (p = 0.038 vs. proliferative phase) but not in the endometriosis group. Limitations: We cannot determine whether endometriosis causes the abnormal expression of alpha-inhibin and betaglycan in the eutopic endometrium or if this alteration already existed before the establishment of endometriotic lesions. Conclusion: Our findings suggest an abnormally increased expression of alpha-inhibin mRNA (not protein) and betaglycan (mRNA and protein) in the secretory-phase endometrium of women with endometriosis.