cassette transporter G2 expression
in endometriosis and in endometrium
from patients with and without
Sachiko Matsuzaki, M.D.,
and Claude Darcha, M.D.
CHU Clermont-Ferrand, CHU Estaing, Chirurgie Gyn
e d'Auvergne, ISIT
CNRS, ISIT UMR6284; and
Service d'Anatomie et Cytologie Pathologiques, Centre de Biologie, CHU
Clermont-Ferrand, Clermont-Ferrand, France
Objective: To investigate adenosine triphosphate (ATP)-binding cassette transporter G2 (ABCG2) expression in endometriosis and in
samples of endometrium from patients with and without endometriosis.
Design: Prospective study.
Setting: University hospital.
Patient(s): Patients with and without endometriosis.
Intervention(s): Endometrial and endometriotic tissues obtained throughout the menstrual cycle.
Main Outcome Measure(s): Density of ABCG2
microvessels, density of CD31
Result(s): No statistically signiﬁcant differences in the density of ABCG2
microvessels were observed between endometrium of pa-
tients with and without endometriosis in the proliferative phase and early, middle, and late secretory phases. The density of ABCG2
microvessels was statistically signiﬁcantly higher in the menstrual endometrium of patients with endometriosis compared with patients
without endometriosis. The density of ABCG2
microvessels was reduced in the ectopic endometrium compared with matched eutopic
endometrium except in cases of deep inﬁltrating endometriosis. The density of ABCG2
microvessels was statistically signiﬁcantly
higher in deep inﬁltrating endometriosis compared with ovarian endometriosis and red and black peritoneal lesions throughout the
Conclusion(s): ABCG2 is strongly expressed in the endothelial cells of microvessels of eutopic endometrium, and the density of
microvessels is reduced in ectopic endometrium except in cases of deep inﬁltrating en-
microvessels may represent an integral part of the pathophysiology of
deep inﬁltrating endometriosis. (Fertil Steril
2012;98:1512–20. Ó2012 by American Society
for Reproductive Medicine.)
Key Words: ATP-binding cassette transporter G2, endometriosis, endometrium, microvessel
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rowing evidence suggests that
endometriosis may arise from
stem cells (1–5). Candidate
tissue-speciﬁc adult stem cells have
been identiﬁed in several tissues based
on the side population (SP) phenotype
(6, 7). Several groups have isolated
and characterized endometrial
side population (ESP) cells (8–11).
Masuda et al. (10) demonstrated that
ESP cells can generate functional
endometrial tissue comprising glands,
stroma, immune cells, and
vascular components when they are
transplanted under the kidney capsule
of severely immunodeﬁcient mice. The
SP phenotype is linked to the presence
of adenosine triphosphate (ATP)
binding cassette (ABC) transporters,
Received April 26, 2012; revised June 25, 2012; accepted July 23, 2012; published online August 25,
S.M. has nothing to disclose. C.D. has nothing to disclose.
Supported in part by Karl Storz Endoscopy & GmbH (Tuttlingen, Germany).
Presented in part at the 67th annual meeting of the American Society for Reproductive Medicine, Or-
lando, Florida, October 15–19, 2011.
Reprint requests: Sachiko Matsuzaki, M.D., CHU Clermont-Ferrand, CHU Estaing, Chirurgie
ecologique, 1, Place Lucie Aubrac, 63003 Clermont-Ferrand C
edex 1, France (E-mail:
Fertility and Sterility® Vol. 98, No. 6, December 2012 0015-0282/$36.00
Copyright ©2012 American Society for Reproductive Medicine, Published by Elsevier Inc.
1512 VOL. 98 NO. 6 / DECEMBER 2012