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ObjectiveTo study the role of endometriosis-inducing factor on the differentiation of cultured stem cells into endometrial cells. MethodsThis was a multicenter prospective cohort case-control study where 323 women were examined, but only 134 infertile women were recruited and compiled with the inclusion criteria. The study group comprised 64 women in whom laparoscopy showed endometriotic lesions, and the control group included 70 women free of endometriotic implants. The women’s sera were cocultured with mesenchymal stem cells, which were followed up weekly by quantitative real-time PCR to examine the expression of SPARC (secreted protein, acidic, cysteine-rich) and MYC (myelocytomatosis) genes using the method. ResultsBy coculturing the serum of women with endometriosis and the control group with stem cells, none of the cultures of the sera of women within the control group showed any changes in the normal expression of either SPARC or MYC gene levels. Furthermore, the stem cells were normally multiplying in the same cell line during the entire duration of the study. Nevertheless, stem cells that were cocultured with sera from women with endometriosis showed upregulation of the SPARC gene mRNA with mean respiratory quotient of 3.534±1.129, whereas the MYC gene mRNA was downregulated with a mean respiratory quotient of 0.488±0.104. ConclusionThe sera of women with endometriosis were able to induce transformation of mesenchymal stem cells into endometrial-like cells on a molecular basis. This evidence supports the endometriosis-inducing factor theory of endometriosis and may have tremendous effect on the therapeutic implications of this debilitating condition.

Multicenter cohort molecular evidence of the presence of endometriosis-inducing factor (mir-130a) as a potent regulator of gene expression in endometriosis