Increased expression of stemness genes REX-1, OCT-4, NANOG, and SOX-2 in women with ovarian endometriosis versus normal endometrium: A case-control study

Background: Endometriosis is a common, chronic inflammatory disease which isdefined as an overgrowth of endometrial tissue outside the uterine cavity. The etiologyof this disease is complex and multifactorial but there is a strong evidence that supportsthe presence of endometrial stem cells and their possible involvement in endometriosis.Objective: In this study, we analyzed the mRNA expression of REX-1 stemness geneand reconsidered three other stemness genes SOX-2, NANOG, OCT-4 in women withendometriosis compared to normal endometrium.Materials and Methods: Ten ectopic and ten eutopic tissue samples along with 23normal endometrium specimens were recruited in this study. The expression levels ofOCT-4, NANOG, SOX-2, and REX-1 genes were evaluated by the quantitative real-timepolymerase chain reaction.Results: The transcription levels of OCT-4, NANOG, and SOX-2 mRNA were significantlyincreased in ectopic lesions compared with eutopic and control group (p = 0.041, p= 0.035, p = 0.048), although the REX-1 mRNA increase was not significant betweenendometriosis and control groups. Also, there were differences in the expression levelof these genes in normal endometrium during the menstrual cycles (p = 0.031, p = 0.047,p = 0.031).Conclusion: Based on our data, we confirm the dynamic role of stemness genesin proliferation and growth of normal endometrium during the menstrual cycle andconclude that differential expression levels of these genes may contribute to thepathophysiology of endometriosis.

Keywords:

Endometriosis , Stemness genes