Long-term, hormone-responsive organoid cultures of human endometrium in a chemically-defined medium

In humans, the endometrium, the uterine mucosal lining, undergoes dynamic changes throughout the menstrual cycle and pregnancy. Despite the importance of the endometrium as the site of implantation and nutritional support for the conceptus, there are no long-term culture systems that recapitulate endometrial function in vitro. We adapted conditions used to establish human adult stem-cell-derived organoid cultures to generate three-dimensional cultures of normal and decidualized human endometrium. These organoids expand long-term, are genetically stable and differentiate following treatment with reproductive hormones. Single cells from both endometrium and decidua can generate a fully functional organoid. Transcript analysis confirmed great similarity between organoids and the primary tissue of origin. On exposure to pregnancy signals, endometrial organoids develop characteristics of early pregnancy. We also derived organoids from malignant endometrium, and so provide a foundation to study common diseases, such as endometriosis and endometrial cancer, as well as the physiology of early gestation.

[1]  K. Kaestner,et al.  Foxa2 Is Essential for Mouse Endometrial Gland Development and Fertility1 , 2010, Biology of reproduction.

[2]  A. Ferenczy,et al.  Studies on the cytodynamics of human endometrial regeneration. III. In vitro short-term incubation historadioautography. , 1979, American journal of obstetrics and gynecology.

[3]  C. Gargett,et al.  Endometrial stem/progenitor cells: the first 10 years , 2015, Human reproduction update.

[4]  M. Sousa,et al.  Human Endometrium Ultrastructure During the Implantation Window , 2011, Reproductive Sciences.

[5]  Hans Clevers,et al.  Long-term expansion of epithelial organoids from human colon, adenoma, adenocarcinoma, and Barrett's epithelium. , 2011, Gastroenterology.

[6]  H. Koistinen,et al.  Glycodelins , 1998, Trends in Endocrinology & Metabolism.

[7]  S. Dey,et al.  Kruppel-like factor 5 (KLF5) is critical for conferring uterine receptivity to implantation , 2012, Proceedings of the National Academy of Sciences.

[8]  S. Bulun,et al.  Stromal PRs mediate induction of 17beta-hydroxysteroid dehydrogenase type 2 expression in human endometrial epithelium: a paracrine mechanism for inactivation of E2. , 2001, Molecular endocrinology.

[9]  Hayley E. Francies,et al.  Prospective Derivation of a Living Organoid Biobank of Colorectal Cancer Patients , 2015, Cell.

[10]  Hans Clevers,et al.  In vitro expansion of single Lgr5+ liver stem cells induced by Wnt-driven regeneration , 2013, Nature.

[11]  A. Brivanlou,et al.  Self-organization of the in vitro attached human embryo , 2016, Nature.

[12]  K. Niakan,et al.  Self-Organization of the Human Embryo in the Absence of Maternal Tissues , 2016 .

[13]  T. Spencer,et al.  Endometrial Glands Are Essential for Blastocyst Implantation and Decidualization in the Mouse Uterus , 2013, Biology of reproduction.

[14]  D. Bailey,et al.  Immunohistochemical sex steroid receptor distribution in endometrium from long-term subdermal levonorgestrel users and during the normal menstrual cycle. , 1993, Human reproduction.

[15]  Patrick Neven,et al.  Endometrial cancer. , 2005, Lancet.

[16]  J. Koudstaal,et al.  Immunocytochemical analysis of oestrogen receptors and progesterone receptors in the human uterus throughout the menstrual cycle and after the menopause , 1992, Journal of reproduction and fertility.

[17]  B. Quade,et al.  Targeted development of specific biomarkers of endometrial stromal cell differentiation using bioinformatics: the IFITM1 model , 2014, Modern Pathology.

[18]  C. Gargett,et al.  Reply: An update on endometrial stem cells and progenitors by Deepa Bhartiya. , 2016, Human reproduction update.

[19]  M. Saegusa,et al.  Transcriptional up-regulation of Sox9 by NF-κB in endometrial carcinoma cells, modulating cell proliferation through alteration in the p14(ARF)/p53/p21(WAF1) pathway. , 2012, The American journal of pathology.

[20]  T. Horn,et al.  Isolation and culture of human endometrial cells in a three-dimensional culture system. , 1994, Journal of reproduction and fertility.

[21]  C. Gargett,et al.  Reepithelialization of the uterine surface arises from endometrial glands: evidence from a functional mouse model of breakdown and repair. , 2010, Endocrinology.

[22]  C. Kessler,et al.  Progesterone-dependent decidualization of the human endometrium is mediated by cAMP , 1997, Endocrine.

[23]  E. Jauniaux,et al.  Uterine glands provide histiotrophic nutrition for the human fetus during the first trimester of pregnancy. , 2002, The Journal of clinical endocrinology and metabolism.

[24]  C. Gargett,et al.  Clonogenicity of Human Endometrial Epithelial and Stromal Cells1 , 2004, Biology of reproduction.

[25]  T. Spencer,et al.  Prolactin Receptor and Uterine Milk Protein Expression in the Ovine Endometrium During the Estrous Cycle and Pregnancy1 , 2000, Biology of reproduction.

[26]  E. Cuppen,et al.  Identification of Multipotent Luminal Progenitor Cells in Human Prostate Organoid Cultures , 2014, Cell.

[27]  Wei Zhang,et al.  Human chorionic gonadotropin (hCG) regulation of galectin-3 expression in endometrial epithelial cells and endometrial stromal cells. , 2013, Acta histochemica.

[28]  T. Spencer,et al.  Fibroblast Growth Factor-10: A Stromal Mediator of Epithelial Function in the Ovine Uterus , 2000, Biology of reproduction.

[29]  R. Vihko,et al.  Immunohistochemical localization of 17 beta-hydroxysteroid dehydrogenase in the human endometrium during the menstrual cycle. , 1991, Laboratory investigation; a journal of technical methods and pathology.

[30]  H. Mollenkopf,et al.  The Notch and Wnt pathways regulate stemness and differentiation in human fallopian tube organoids , 2015, Nature Communications.

[31]  M. Paidas,et al.  PreImplantation Factor (PIF) promoting role in embryo implantation: increases endometrial Integrin-α2β3, amphiregulin and epiregulin while reducing betacellulin expression via MAPK in decidua , 2012, Reproductive Biology and Endocrinology.

[32]  Hans Clevers,et al.  Designer matrices for intestinal stem cell and organoid culture , 2016, Nature.

[33]  T. Spencer,et al.  Evidence that absence of endometrial gland secretions in uterine gland knockout ewes compromises conceptus survival and elongation. , 2002, Reproduction.

[34]  U. Stenman,et al.  Structural studies, localization in tissue and clinical aspects of human endometrial proteins. , 1988, Journal of reproduction and fertility. Supplement.

[35]  D. Armant,et al.  Physiological and molecular determinants of embryo implantation. , 2013, Molecular aspects of medicine.

[36]  D. Charnock-Jones,et al.  Human Early Placental Development: Potential Roles of the Endometrial Glands , 2007, Placenta.

[37]  Yoshiakira Kanai,et al.  Mouse Sox17 haploinsufficiency leads to female subfertility due to impaired implantation , 2016, Scientific Reports.

[38]  J. Arias-Stella The Arias-Stella Reaction: Facts and Fancies Four Decades After , 2002, Advances in anatomic pathology.

[39]  Bon-Kyoung Koo,et al.  Modeling mouse and human development using organoid cultures , 2015, Development.

[40]  G. Wagner,et al.  Transformation of a transposon into a derived prolactin promoter with function during human pregnancy , 2012, Proceedings of the National Academy of Sciences.

[41]  T. Zglinicki,et al.  SSEA-1 isolates human endometrial basal glandular epithelial cells: phenotypic and functional characterization and implications in the pathogenesis of endometriosis. , 2013, Human reproduction.

[42]  Hans Clevers,et al.  In vitro expansion of human gastric epithelial stem cells and their responses to bacterial infection. , 2015, Gastroenterology.

[43]  T. Spencer Biological Roles of Uterine Glands in Pregnancy , 2014, Seminars in Reproductive Medicine.

[44]  M. Goodheart,et al.  Conditional deletion of Sox17 reveals complex effects on uterine adenogenesis and function. , 2016, Developmental biology.

[45]  E. Jauniaux,et al.  Endometrial glands as a source of nutrients, growth factors and cytokines during the first trimester of human pregnancy: A morphological and immunohistochemical study , 2004, Reproductive biology and endocrinology : RB&E.

[46]  S. Bell Secretory endometrial/decidual proteins and their function in early pregnancy. , 1988, Journal of reproduction and fertility. Supplement.

[47]  G. Burton,et al.  Derivation and long-term expansion of human endometrial and decidual organoids. , 2017 .

[48]  P. Martikainen,et al.  A novel organotypic culture model for normal human endometrium: regulation of epithelial cell proliferation by estradiol and medroxyprogesterone acetate. , 2005, Human reproduction.

[49]  Bell Sc Secretory endometrial/decidual proteins and their function in early pregnancy. , 1988 .

[50]  C. Longcope,et al.  The basalis of the primate endometrium: a bifunctional germinal compartment. , 1989, Biology of reproduction.

[51]  A. Jegga,et al.  Estrogen mediated epithelial proliferation in the uterus is directed by stromal Fgf10 and Bmp8a , 2014, Molecular and Cellular Endocrinology.

[52]  D. Charnock-Jones,et al.  Endoplasmic reticulum stress exacerbates ischemia‐reperfusion‐induced apoptosis through attenuation of Akt protein synthesis in human choriocarcinoma cells , 2007, FASEB journal : official publication of the Federation of American Societies for Experimental Biology.

[53]  Hans Clevers,et al.  Lrig1 controls intestinal stem cell homeostasis by negative regulation of ErbB signalling , 2012, Nature Cell Biology.

[54]  Hans Clevers,et al.  OLFM4 is a robust marker for stem cells in human intestine and marks a subset of colorectal cancer cells. , 2009, Gastroenterology.

[55]  G. Greene,et al.  Immunohistochemical analysis of human uterine estrogen and progesterone receptors throughout the menstrual cycle. , 1988, The Journal of clinical endocrinology and metabolism.

[56]  A. Ferenczy Studies on the cytodynamics of human endometrial regeneration. I. Scanning electron microscopy. , 1976, American journal of obstetrics and gynecology.

[57]  J. Sugawara,et al.  Increased secretion of hepatocyte growth factor by eutopic endometrial stromal cells in women with endometriosis. , 1997, Fertility and sterility.

[58]  Hans Clevers,et al.  Long-Term Culture of Genome-Stable Bipotent Stem Cells from Adult Human Liver , 2015, Cell.

[59]  Hans Clevers,et al.  Unlimited in vitro expansion of adult bi-potent pancreas progenitors through the Lgr5/R-spondin axis , 2013, The EMBO journal.

[60]  J. Deng,et al.  Continuous cell supply from a Sox9-expressing progenitor zone in adult liver, exocrine pancreas and intestine , 2011, Nature Genetics.

[61]  Allon M. Klein,et al.  Interfollicular Epidermal Stem Cells Self-Renew via Autocrine Wnt Signaling , 2013, Science.