Journal
REPRODUCTIVE MEDICINE AND BIOLOGY
Volume 17, Issue 3, Pages 220-227Publisher
WILEY
DOI: 10.1002/rmb2.12088
Keywords
decidualization; endometrial stromal cells; endometrium; heart and neural crest derivatives expressed 2; progesterone
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Funding
- Japan Society for the Promotion of Science KAKENHI [17K11260, 15K20169]
- Grants-in-Aid for Scientific Research [17K11260, 15K20169] Funding Source: KAKEN
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BackgroundDecidualization of the human endometrium, which involves a dramatic morphological and functional differentiation of human endometrial stromal cells (ESCs), is essential for the establishment of a successful pregnancy. Decidualization results from a complex interplay of transcription factors, morphogens, cytokines, cell cycle regulators, and signaling pathways. MethodsBased on a literature review, the regulation of, and the molecular mechanisms involved in, the decidualization of the endometrium are described. Main findingsProgesterone, together with proteins that are regulated by progesterone and/or cyclic adenosine monophosphate, including homeobox A10, forkhead box O1, signal transducers and activators of transcription, and heart and neural crest derivatives expressed transcript 2, forms a critical network for ESC decidualization and is a prerequisite to successful implantation. Decidualized ESCs contribute to the microenvironment at the feto-maternal interface and its direct or indirect influence on extracellular matrix remodeling, regulation of the local immune response, anti-oxidative stress, and angiogenesis (vascular maturation). Impairment of this process is associated with a variety of pregnancy disorders, including infertility, recurrent miscarriages, and uteroplacental disorders. ConclusionA deeper understanding of the process of decidualization is expected to provide new insights into the fields of reproductive biology and reproductive medicine.
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