Matson BS, et al. - Researchers investigated adrenomedullin (Adm, ADM) as a downstream target of signal transducer and activator of transcription 3 (STAT3) in endometrial cells. In addition, they tested midregional proadrenomedullin (MR-proADM) as a biomarker of endometriosis. Outcomes suggested MR-proADM could serve as a biomarker of endometriosis. Whether elevated MR-proADM levels are secondary to the estrogenic and inflammatory properties of endometriosis or an inciting pathogenic factor needs further assessment.

Methods

• In plasma from women with and without endometriosis, researchers performed a cross-sectional analysis of Adm expression in eutopic endometrium and of MR-proADM.
• MR-proADM levels were prospectively studied in women with endometriosis undergoing surgical resection of ectopic lesions.
• This study was done at academic medical centers.
• Eutopic endometrial biopsies were obtained from 15 patients with endometriosis and 11 healthy control subjects; and for MR-proADM analysis, plasma was collected from 28 patients with endometriosis and 19 healthy control subjects.
• After activation of STAT3 by interleukin-6 (IL-6) in Ishikawa cells, they measured Adm mRNA levels in accordance to quantitative real-time polymerase chain reaction.
• In eutopic endometrial biopsies from women with endometriosis compared with healthy donors, immunohistochemistry for ADM was assessed.
• Plasma from healthy women and women with endometriosis who subsequently underwent surgical resection of ectopic lesions were investigated for MR-proADM levels by commercial immunoassay.

Results

• In Ishikawa cells, up-regulation of Adm mRNA expression was observed in association with activation of STAT3 by IL-6.
• The eutopic endometrium of women with endometriosis showed elevated ADM protein levels.
• Women with endometriosis showed higher MR-proADM concentrations but these were not correlated with disease stage, corrected by surgery, or predictive of fertility outcome.