Abnormal activation of the sonic hedgehog signaling pathway in endometriosis and its diagnostic potency

Objective: To investigate the abnormal expression of sonic hedgehog (SHH) signaling molecules in 52 eutopic endometrial tissues and its diagnostic potency in endometriosis. Design: Retrospective study. Setting: University hospital. Patient(s): Twenty-six women with histologically confirmed endometriosis and 26 women with histologically normal endometria who were undergoing curettage or hysterectomy were selected. Intervention(s): None. Main Outcome Measure(s): The mRNA and protein levels of molecules in the SHH signaling pathway. Result(s): The levels of SHH, smoothened, GLI family zinc finger 3, and its downstream signaling transcription factor (GLI1) not only were upregulated in the eutopic endometrium of endometriosis compared with the control endometrium, but also independently predicted the onset and severity of the disease. Conclusion(s): This study is the first to reveal differences in the activation of the SHH signaling pathway between women with and without endometriosis and suggests that the SHH signaling pathway has potential in the diagnosis of endometriosis. (C) 2018 by American Society for Reproductive Medicine.