In human endometrium, cytokines and growth factors that vary periodically during the menstrual cycles have been suggested to play various roles in uterine function. In the present study, differential gene expression in human endometrium between the proliferative and the secretory phases was investigated by using a human cDNA expression array system. Human interleukin (IL)-15 was identified as an up-regulated transcription product during the secretory phase, in comparison with the proliferative phase, and therefore its expression in human uterus was examined by Northern blot analysis. In human endometrium, expression of IL-15 mRNA significantly increased during the secretory phase compared with the proliferative phase (P < 0.01). The most abundant expression of IL-15 mRNA during the menstrual cycle was observed in the midsecretory phase. In the first trimester pregnancy, the expression of IL-15 mRNA in the decidua was significantly higher than that in the chorionic villi (P < 0.01). By using an in-vitro decidualization with human endometrial stromal cells, it was demonstrated that the expression of IL-15 mRNA is up-regulated during progesterone-induced decidualization. These results suggest that IL-15 plays a role in uterine function during pregnancy, as well as during the menstrual cycle.

Differentiation of endometrial stromal cells (decidualization) plays a crucial role in embryo implantation and maintenance of pregnancy. While progesterone is a key factor in regulating endometrial cell decidualization, the molecular mechanisms remain unclear. In the present study, we investigated the effect of gene transcription in human endometrial stromal cells (ESC) by progesterone, oestrogen or vehicle using the polymerase chain reaction-based differential display methodology. A transcript which is down-regulated by progesterone, but not by vehicle and oestrogen, was identified from a differential display band and the progesterone sensitivity of its expression was verified in Northern blot analysis. The level of the gene expression in progesterone-treated ESC was approximately 60% of that in the vehicle- and oestrogen-treated ESC. This cDNA was revealed to be human CD63 antigen, a recently identified member of the transmembrane 4 superfamily. The inhibitory effect of progesterone is observed within 30 min after hormone treatment. In human endometrium, CD63 mRNA levels were significantly decreased (P < 0.05) during the secretory phase compared with levels during the proliferative phase. This down-regulation of CD63 in vivo elevated levels of progesterone in the secretory phase. These results suggest that CD63 transcription is down-regulated by progesterone in human endometrium.

A 30-year-old pregnant womancomplained of muscle weakness at 29 weeks' gestation. She was hypertensive with severe hypokalemia.Lowerplasma renin activity and higher aldosterone level than the normal values in pregnancy suggested primary aldosteronism. A cesarean delivery was performed at 31 weeks' gestation because of pulmonary congestion. The neonatal course was uncomplicated. The laparoscopic adrenalectomy for a 2.0-cm right adrenal adenomaresulted in normalizing of her blood pressure and serum potassium level. Although primary aldosteronism is rare, especially during pregnancy, it should be always considered as one of etiologies of hypertension in pregnancy. (Internal Medicine 38: 36-39, 1999)

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