The role of extracellular matrix on diminished ovarian reserve associated with endometriosis

2021 Fiscal Year Final Research Report

• Project/Area Number: 18K09294
• Research Category: Grant-in-Aid for Scientific Research (C)
• Allocation Type: Multi-year Fund
• Section: 一般
• Review Section: Basic Section 56040:Obstetrics and gynecology-related
• Research Institution: Nagasaki University
• Principal Investigator: Kitajima Michio 長崎大学, 医歯薬学総合研究科(医学系), 准教授 (50380845)
• Co-Investigator(Kenkyū-buntansha): 村上 直子 長崎大学, 医歯薬学総合研究科(医学系), 客員研究員 (30768718)
• Project Period (FY): 2018-04-01 – 2022-03-31
• Keywords: 子宮内膜症 / 不妊症 / 卵巣予備能 / 局所炎症 / 線維化 / 初期卵胞発育 / 卵胞周囲間質

Outline of Final Research Achievements

Endometriosis is an estrogen dependent chronic inflammatory disease that manifested by chronic pelvic pain and infertility. The cause of endometriosis associated infertility is multifactorial and diminished ovarian reserve is one of the manifestations. In this study, we evaluated the associations between the fate of early developing ovarian follicles and surrounding stroll cells and extracellular components in endometriosis affected ovary. Ovarian cortex derived from women with endometriosis showed increased fibrotic area similar to ovarian cortex exposed to inflammatory environments. We also demonstrated that the area od stroma surrounding growing secondary to early prenatal follicles were decreased in fibrotic ovarian cortex. aSMA expression in these cells are also decreased. We could not demonstrate significant relationship between fibrilin expression and local inflammations.

Free Research Field

産科婦人科学

Academic Significance and Societal Importance of the Research Achievements

不妊に悩むカップルに有効な治療手段を提供することは，晩婚化・少子化が著しい本邦の現況と相俟って，産婦人科領域で重要な研究領域である．子宮内膜症は不妊や疼痛を主徴とする疾患で思春期から閉経期まで様々なライフステージでの女性の健康に影響を及ぼす．子宮内膜症女性では慢性的な骨盤内炎症に起因する卵巣機能低下が問題であるが，本研究では，卵巣間質に存在する初期卵胞発育における周囲間質組織の変化に着目し，細胞外基質による間質構造の維持と発育卵胞周囲の形質転換および局所炎症によるそれらの破綻が卵巣機能低下に関連することを見出し，局所の線維化の制御が卵巣機能の維持に有用な治療法になり得ることを提示した．