Decidualization of Endometriosis in Macaques

Abstract

The decidua is the superficial portion of endometrium that transforms, or decidualizes, under the influence of progesterone to nourish the early embryo during pregnancy. Deciduae outside of the uterus are found in nearly 100% of human pregnancies. This condition known as deciduosis may mimic malignancy, resulting in additional diagnostic procedures that place the mother or baby or both at risk. Deciduosis has been described in both Old and New World nonhuman primates in conjunction with pregnancy and after treatment with exogenous progestins. Here the authors present 6 cases of deciduosis associated with endometriotic lesions in female rhesus and cynomolgus macaques (Macaca mulatta and Macaca fascicularis). Full diagnostic necropsies with histological analyses were performed on all animals. Deciduae were stained with hematoxylin & eosin and by immunohistochemistry for vimentin, CD10, progesterone receptor, estrogen receptor, desmin, cytokeratin, kermix P8, chorionic gonadotropin, human placental lactogen, and calretinin. The most common clinical signs were abdominal pain (4 of 6) and anorexia (2 of 6). At necropsy, macaque uteri were often enlarged or disfigured (4 of 6) with abundant fibrous adhesions (5 of 6). Affected tissue consisted of epithelial-lined cysts and decidualized stroma with scattered gamma/delta T cells. Decidualized stromal cells were large and polyhedral with abundant cytoplasm and round, vesicular nuclei. They stained positive for vimentin, CD10, progesterone and estrogen. In summary, these cases illustrate deciduosis in 6 nonhuman primates with endometriosis. Understanding decidualization in nonhuman primates will aid in elucidating the pathophysiology of deciduosis during pregnancy or endometriosis and potentially lead to new interventions.

Proliferative Lesions of the Endometrium of 50 Four-Toed Hedgehogs (Atelerix albiventris)

“…35 In animals, CD10 expression has been detected in the endometrial stromal and decidual cells of monkeys. 6 However, the uterine stromal cells of cats and rabbits are negative for CD10 according to tests performed using the same monoclonal antibody. 11,46 PR and WT1 are expressed in both normal and neoplastic endometrial stromal cells.…”

Morphological and immunohistochemical characterization of spontaneous endometriosis in rhesus macaques (Macaca mulatta)

“…Evidence for infertility associated with endometriosis is also described in several animal studies as well as human patients (reviewed in Giudice and Kao, 2004). As shown, for example, by data from IVF (in vitro fertilization) treatment, this is mainly caused by poor ovarian reserve in advanced disease, low oocyte quality, impaired embryo survival, and poor im-plantation capacity, most probably due to adverse effects of peritoneal fluid containing high concentrations of cytokines, growth factors, and activated macrophages in patients with endometriosis (Barnhart et al, 2002;Olivennes, 2003;Taketani et al, 1992). The course of the disease and clinical symptoms with endometriosis are highly variable and closely associated with the nature and distribution of lesions (Fanton et al, 1986;Mounsey et al, 2006).…”

Tubectomy of Pregnant and Non-pregnant Female Balinese Macaques (Macaca Fascicularis) With Post-operative Monitoring

“…The incidence of spontaneous endometriosis in a breeding colony of Macaca fascicularis has been reported to be 28.7% ( 63 ) in aging females. Lesions of endometriosis have recently been characterized in long-tailed macaques and involved fibrous adhesions, especially between the omentum and the uterus, liver, spleen, and urinary bladder ( 64 ). The same paper also describes cases where one or both ovaries could not be identified and were suspected to be incorporated or effaced by the fibrous adhesions.…”