PLoS ONE (Jan 2019)

Plasminogen activator inhibitor-1 (PAI-1) expression in endometriosis.

  • Fahad T Alotaibi,
  • Bo Peng,
  • Christian Klausen,
  • Anna F Lee,
  • Amr O Abdelkareem,
  • Natasha L Orr,
  • Heather Noga,
  • Mohamed A Bedaiwy,
  • Paul J Yong

DOI
https://doi.org/10.1371/journal.pone.0219064
Journal volume & issue
Vol. 14, no. 7
p. e0219064

Abstract

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PurposeDeep infiltrating endometriosis (DIE) is defined as an endometriotic lesion penetrating to a depth of >5 mm and is associated with pelvic pain, but the underlying mechanisms are unclear. Our objective is to investigate whether plasminogen activator inhibitor-1 expression (PAI-1) in endometriotic tissues is increased in women with DIE.MethodsIn this blinded in vitro study, immunohistochemistry and Histoscore were used to examine the expression of PAI-1 in glandular epithelium (GECs) and stroma (SCs) in a total of 62 women: deep infiltrating uterosacral/rectovaginal endometriosis (DIE; n = 13), ovarian endometrioma (OMA; n = 14), superficial peritoneal uterosacral/cul-de-sac endometriosis (SUP; n = 23), uterine (eutopic) endometrium from women with endometriosis (UE; n = 6), and non-endometriosis eutopic endometrium (UC; n = 6). The following patient characteristics were also collected: age, American Fertility Society stage, hormonal suppression, phase of menstrual cycle, dysmenorrhea score and deep dyspareunia score.ResultsPAI-1 expression in GECs and SCs of the DIE group was significantly higher than that of SUP group (p = 0.01, p = 0.01, respectively) and UE group (p = 0.03, p = 0.04, respectively). Interestingly, increased PAI-1 expression in GECs and SCs was also significantly correlated with increased dysmenorrhea (r = 0.38, p = 0.01; r = 0.34, p = 0.02, respectively).ConclusionsWe found higher expression of PAI-1 in DIE, and an association between PAI-1 and worse dysmenorrhea.