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Original articles
miRNA-223 expression in patient-derived eutopic and ectopic endometrial stromal cells and its effect on epithelial-to-mesenchymal transition in endometriosis
Yuan Xuea, Xueyan Linb, Tingting Shia, Yongjie Tiana,
Corresponding author
tougaoya2020@163.com

Corresponding author.
a Department of Obstetrics and Gynecology, Shandong Provincial Hospital, Cheeloo College of Medicine, Shandong University, Shandong, China
b Department of Obstetrics and Gynecology, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Shandong, China
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0001" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0009">Introduction</span><p id="para0009" class="elsevierStylePara elsevierViewall">Endometriosis is a condition of the female reproductive tract&#44; which generally occurs in women of childbearing age&#46; It is characterized by the presence of active endometrial tissue &#40;glands and stroma&#41; outside the womb&#46; The incidence rate of endometriosis continues to increase every year and affects between 10&#37; and 15&#37; of the female population&#46; Common symptoms include pelvic pain and infertility&#44; which severely compromise the quality of life of patients&#46;<a class="elsevierStyleCrossRef" href="#bib0001"><span class="elsevierStyleSup">1</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0002"><span class="elsevierStyleSup">2</span></a></p><p id="para0010" class="elsevierStylePara elsevierViewall">Endometriosis&#44; defined as the presence of endometrial glandular and stromal cells outside the uterine cavity&#44; is a common gynecological disease with poorly understood pathogenesis&#46; Eutopic and ectopic stromal cells from patients with endometriosis exhibit differential invasive&#44; adhesive&#44; and proliferative behavior&#46; Therefore&#44; the characterization of the differences and similarities between the eutopic and ectopic endometrium is arguably a first important step toward the understanding of the pathogenesis of endometriosis&#46; MicroRNAs &#40;miRNAs&#41; are endogenous non-coding RNAs with a length of 19&#8211;23 nucleotides&#44; which regulate gene expression at the transcriptional or post-transcriptional level&#44; participating in diverse cellular processes&#46;<a class="elsevierStyleCrossRef" href="#bib0003"><span class="elsevierStyleSup">3</span></a> Human miRNA-223 is located on the X chromosome&#44; and its target genes are known to be involved in various biological processes&#44; including signal transduction&#44; transcriptional regulation&#44; as well as cell growth and development&#46; Recent studies evaluating the function of miRNA-223 reported that it modulates inflammation&#44; infection&#44; and cancer development&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> Further&#44; miRNA-223 is known to be upregulated in the ectopic endometrium of patients with endometriosis when compared to that in the corresponding eutopic endometrium&#46;<a class="elsevierStyleCrossRef" href="#bib0005"><span class="elsevierStyleSup">5</span></a> In addition&#44; patient-derived eutopic endometrium stromal cells &#40;SCs&#41; exhibited increased miRNA-223 expression compared to the surrounding epithelial cells&#46;<a class="elsevierStyleCrossRef" href="#bib0006"><span class="elsevierStyleSup">6</span></a> miRNA-223 was reported to be involved in Epithelial-to-Mesenchymal Transition &#40;EMT&#41; in various diseases&#46; In cervical cancer&#44; the expression of miRNA-223 was lower than in normal tissues&#44; promoting EMT in HeLa cells&#46;<a class="elsevierStyleCrossRef" href="#bib0007"><span class="elsevierStyleSup">7</span></a> Studies have also confirmed the occurrence of EMT during endometriosis&#46;<a class="elsevierStyleCrossRef" href="#bib0008"><span class="elsevierStyleSup">8</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0009"><span class="elsevierStyleSup">9</span></a> Thus&#44; miRNA-223 may be a key regulator of EMT during endometriosis&#46; The aim of this study was to confirm miRNA-223 expression in SCs from patient samples and explore its role in EMT during endometriosis&#46;</p></span><span id="sec0002" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0010">Materials and methods</span><span id="sec0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0011">Clinical specimens</span><p id="para0011" class="elsevierStylePara elsevierViewall">Endometrial samples were collected from 40 patients who were hospitalized at the Shandong Provincial Hospital&#44; Cheeloo College of Medicine&#44; Shandong University between August 2019 and October 2020&#46; Eutopic SCs &#40;EuSCs&#44; 16 cases&#41; and ectopic SCs &#40;EcSCs&#44; 10 cases&#41; were obtained from 26 patients with endometriosis&#46; Control cells were obtained from the 14 remaining patients diagnosed with hysteromyoma&#46; All the samples used in this study were evaluated and confirmed by a surgical pathologist&#46; The following patients were included&#58; females who were of childbearing age&#59; had a regular menstrual history&#59; had no history of sex hormone-related diseases except for endometriosis&#59; had no malignant tumors&#59; did not receive sex hormone-related drugs for at least 6 months prior to surgery&#59; and agreed to the use of their tissue samples for experimental research&#46; The mean age of the patients was 41&#46;91&#177;7&#46;90 years &#40;range&#44; 23&#8211;55 years&#41;&#46; This study was approved by the Ethics Committee at the Shandong Provincial Hospital&#44; Cheeloo College of Medicine&#44; Shandong University &#40;protocol number SWYX2020-211&#41;&#46; All study participants provided written informed consent before participating in the study&#46;</p></span><span id="sec0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0012">Major materials and reagents</span><p id="para0012" class="elsevierStylePara elsevierViewall">The Dulbecco&#39;s Modified Eagle&#39;s Medium &#40;DMEM&#41;&#47;F12 medium and collagenase used in the isolation and culture of the primary endometrial cells were procured from Sigma &#40;USA&#41;&#46; Fetal bovine serum was produced by BI &#40;Israel&#41; and the lentivirus used for transfection was packaged by Shanghai Jiman Technology Co&#46;&#44; Ltd&#46; The RIPA lysate buffer and the Bicinchoninic Acid &#40;BCA&#41; protein concentration determination kit used in the western blotting were obtained from Shanghai Solebao Biotechnology Co&#46;&#44; Ltd&#46;&#44; whereas the 10&#37; SDS-PAGE reagents were procured from Shanghai Aibisin Biotechnology Co&#46;&#44; Ltd&#46;&#44; whereas rabbit anti-human N-cadherin&#44; rabbit anti-human vimentin&#44; rabbit anti-human slug&#44; were obtained from Shanghai Aibisin Biotechnology Co&#46;&#44; Ltd&#46; Rabbit anti-human &#946;-actin was sourced from Wuhan Elabscience Biotechnology Co&#46;&#44; Ltd&#46; The HRP-labeled goat anti-rabbit secondary antibody used was produced by Beijing Zhongshan Jinqiao Biotechnology Co&#46;&#44; Ltd&#46;&#44; and the ECL luminescence solution used for detection was obtained from Millipore &#40;USA&#41;&#46; Both the CCK-8 and apoptosis detection kits were obtained from Shanghai Dongren Chemical Technology Co&#46;&#44; Ltd&#46;</p></span><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0013">Cell isolation and culture</span><p id="para0013" class="elsevierStylePara elsevierViewall">One gram of endometrial tissue was stripped from the underlying myometrium and dissociated using mechanical and enzymatic digestion as previously described with a few modifications&#46; Briefly&#44; the tissue pieces were washed twice in Phosphate Buffered Saline &#40;PBS&#41; and minced before dissociation in DMEM&#47;F-12 containing 0&#46;1&#37; Bovine Serum Albumin &#40;BSA&#41;&#44; 0&#46;5&#37; collagenase I&#44; 40&#160;&#956;g&#47;mL deoxyribonuclease type I &#40;Sigma Aldrich&#41;&#44; and 1&#37; penicillin&#47;streptomycin for 40&#160;min at 37&#160;&#176;C in a SI50 Orbital Incubator &#40;Stuart Scientific&#41;&#46; The resulting cell solution was filtered through a sterile 70-&#956;m cell strainer &#40;Fisher Scientific&#41; to separate single cells from undigested tissue fragments following isolation&#46; Patient endometrial SCs &#40;EuSCs&#44; EcSCs&#44; and control cells&#41; were then cultured at 37&#160;&#176;C and 5&#37; CO<span class="elsevierStyleInf">2</span> in DMEM supplemented with 10&#37; heat-inactivated fetal bovine serum&#46; Cells were passaged upon reaching 90&#37; confluence&#46;</p></span><span id="sec0006" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0014">Quantitative real-time PCR &#40;qRT-PCR&#41;</span><p id="para0014" class="elsevierStylePara elsevierViewall">When the endometrial SCs reached logarithmic growth&#44; total RNA was extracted using the TRIzol method &#40;Dalian Bao Biological Engineering Co&#46;&#44; Ltd&#41;&#46; This RNA was then used as a template in qRT-PCR assays using a qRT-PCR amplification kit from TaKaRa &#40;Dalian Bao Biological Engineering Co&#46;&#44; Ltd&#41;&#46; The miRNA-223 mimics &#40;sequence 5&#8217;-CGTGTATTTGACAAGCTGAGTT-3&#8217;&#41; were obtained from TaKaRa &#40;Dalian Bao Biological Engineering Co&#46;&#44; Ltd&#46;&#41; and U6 was used as the internal reference for all evaluations&#46; Relative expression was calculated using the 2<span class="elsevierStyleSup">&#8722;&#9651;&#9651;Ct</span> method&#46;</p></span><span id="sec0007" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0015">Lentivirus infection</span><p id="para0015" class="elsevierStylePara elsevierViewall">Before transduction&#44; the optimal Multiplicity of Infection &#40;MOI&#41; value and related transduction conditions were determined as follows&#46; The cells were digested&#44; suspended&#44; and inoculated into a 24-well plate&#46; When the cells reached approximately 50&#37; confluence&#44; each well was treated with 20&#160;&#956;L of lentivirus and allowed to grow for a further 72&#160;h at 37&#160;&#176;C and 5&#37; CO<span class="elsevierStyleInf">2</span>&#46; Following this&#44; transduced cells were evaluated for green fluorescence using a fluorescence microscope&#44; and fluorescence was calculated as a proportion of the total number of cells in the bright-field images&#46;</p></span><span id="sec0008" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0016">Western blot</span><p id="para0016" class="elsevierStylePara elsevierViewall">sh-NC and sh-miR-223 cells were lysed in RIPA buffer and protein concentration was determined using the BCA method&#46; Samples &#40;20&#160;&#956;g protein&#41; were separated by 10&#37; SDS-PAGE&#44; transferred to PVDF membranes&#44; and blocked with 5&#37; skimmed milk for 1h at room temperature&#46; Membranes were then incubated with the appropriate primary antibodies overnight on a shaker at 4&#160;&#176;C&#46; The primary antibody dilutions were as follows&#58; rabbit anti-N-cadherin &#40;1&#58;1000&#41;&#44; rabbit anti-vimentin &#40;1&#58;1000&#41;&#44; rabbit anti-Slug &#40;1&#58;1000&#41;&#44; rabbit anti-&#946;-actin &#40;1&#58;2000&#41;&#46; Membranes were then incubated with the HRP-labeled goat anti-rabbit secondary antibody &#40;1&#58;3000&#41; for 1h at room temperature and then evaluated using an ECL system&#46;</p></span><span id="sec0009" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0017">Wound healing assay</span><p id="para0017" class="elsevierStylePara elsevierViewall">sh-miR-223 and sh-NC cells were also applied to a wound healing assay&#46; Briefly&#44; following digestion and resuspension&#44; the cells were evenly inoculated in 6-well plates and allowed to reach 100&#37; confluence&#46; The authors then created a scratch in the cell monolayer perpendicular to the bottom of the plate using a 10&#160;&#956;L pipette tip&#46; Wells were washed with PBS to remove dislodged cells and 2&#160;mL of serum-free medium was added to each well&#46; The scratch was then observed under an inverted optical microscope and scratch closure was evaluated using Image J software 24&#160;h after initial wounding&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0018">Transwell assay</span><p id="para0018" class="elsevierStylePara elsevierViewall">To evaluate the migratory potential of the treated SCs&#44; the authors used a Transwell chamber assay&#46; These chambers were pre-coated with Matrigel &#40;serum-free medium&#58; Matrigel&#8239;&#61;&#8239;7&#58;1&#41; and sh-miR-223 and sh-NC cells &#40;5&#215;10<span class="elsevierStyleSup">4</span> per well&#41; were seeded in the upper chamber using serum-free medium before adding 600&#160;&#956;l of complete medium to the lower chamber&#46; The cells were incubated at 37&#160;&#176;C and 5&#37; CO<span class="elsevierStyleInf">2</span> for 48&#160;h&#46; Cells in the upper compartment were wiped with a cotton swab and the cells in the bottom chamber were fixed&#44; stained&#44; and evaluated using an optical microscope&#46; Three random high-magnification fields were imaged&#44; and the cells were counted&#46;</p></span><span id="sec0011" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0019">Cell Counting Kit-8 &#40;CCK8&#41; proliferation assay</span><p id="para0019" class="elsevierStylePara elsevierViewall">sh-miR-223 and sh-NC cells were grown to logarithmic phase and then placed in suspension&#46; Cell concentrations were then adjusted to 5&#215;10<span class="elsevierStyleSup">4</span> cells&#47;mL and inoculated in a 96-well plate at 100&#160;&#956;L per well and cultured for 1&#44; 3&#44; 5&#44; or 7 days&#46; The original medium was then changed to 100&#160;&#956;L of medium and 10&#160;&#956;L CCK-8 reagent per well&#44; and the plates were then incubated at 37&#160;&#176;C for 2&#160;h&#46; The absorbance at 450&#160;nm was then determined for each well&#46;</p></span><span id="sec0012" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0020">Apoptosis assays</span><p id="para0020" class="elsevierStylePara elsevierViewall">Cells were digested&#44; collected&#44; and centrifuged&#44; before being washed in PBS twice and then resuspended in 1&#215; binding buffer at an adjusted cell density of 1&#215;10<span class="elsevierStyleSup">6</span>&#160;cells&#47;mL&#46; A total of 100&#160;&#956;L of these cell suspensions &#40;1&#215;10<span class="elsevierStyleSup">5</span> cells&#41; was added to each flow tube and then treated with 5&#160;&#956;L FITC-annexin V and 10&#160;&#956;L Propidium Iodide &#40;PI&#41;&#46; The cells were gently mixed and incubated in the dark at room temperature for 15&#160;min before adding another 400&#160;&#956;L of 1&#215; binding buffer&#46; The cells were then left for 1&#160;h before being evaluated for apoptosis using a flow cytometer&#46;</p></span><span id="sec0013" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0021">Statistical analysis</span><p id="para0021" class="elsevierStylePara elsevierViewall">GraphPad Prism 8&#46;0 software was used for all statistical analyses&#46; The data are expressed as the mean &#177; SD of at least three independent experiments and the Student&#39;s <span class="elsevierStyleItalic">t</span>-test was used to compare values in the sh-miRNA-223 and sh-NC groups&#59; p &#60; 0&#46;05 was considered statistically significant&#46;</p></span></span><span id="sec0014" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0022">Results</span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0023">Expression of miRNA-223 in endometrial SCs</span><p id="para0022" class="elsevierStylePara elsevierViewall">The expression of miRNA-223 in patient-derived endometrial SCs &#40;EuSC and EcSC group&#41; was significantly lower than that in the control group &#40;normal endometrial eutopic SCs&#41; &#40;p &#60; 0&#46;05&#41;&#46; There was no significant difference in miRNA-223 expression between EuSCs and EcSCs derived from endometriosis patients &#40;<a class="elsevierStyleCrossRef" href="#fig0001">Fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0001"></elsevierMultimedia></span><span id="sec0016" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0024">Efficiency of the lentiviral transductions</span><p id="para0023" class="elsevierStylePara elsevierViewall">EuSCs and EcSCs were transduced using lentiviral vectors&#46; Transduction efficiency was observed using a fluorescence microscope&#44; and Green Fluorescent Protein &#40;GFP&#41; expression was evaluated&#46; Both light and fluorescence microscopy were used to determine the efficacy of these infections &#40;<a class="elsevierStyleCrossRef" href="#fig0002">Fig&#46; 2</a>A&#41;&#46; Optimal conditions produced a final transduction efficiency of &#62; 90&#37; and qRT-PCR results confirmed a significant upregulation in miRNA-223 expression in the sh-miR-223 group when compared to that in the sh-NC group &#40;<a class="elsevierStyleCrossRef" href="#fig0002">Fig&#46; 2</a>B&#41;&#46;</p><elsevierMultimedia ident="fig0002"></elsevierMultimedia></span><span id="sec0017" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0025">Expression of the EMT-related proteins PARP-1 and HIF-1&#945; following miRNA-223 upregulation in EuSCs and EcSCs</span><p id="para0024" class="elsevierStylePara elsevierViewall">Western blot revealed that the protein expression of mesenchymal markers N-cadherin&#44; vimentin&#44; and Slug was lower in EuSCs and EcSCs overexpressing miRNA-223 compared to that in the sh-NC control &#40;<a class="elsevierStyleCrossRef" href="#fig0003">Fig&#46; 3</a>&#41;&#44; suggesting that EMT was inhibited following miRNA-223 upregulation&#46;</p><elsevierMultimedia ident="fig0003"></elsevierMultimedia></span><span id="sec0018" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0026">Upregulation of miRNA-223 inhibits cell migration</span><p id="para0025" class="elsevierStylePara elsevierViewall">Wound healing assay results revealed that sh-miR-223 cells experienced a significantly reduced wound healing ability over a 24&#160;h period in response to a scratch in the monolayer when compared to the control &#40;<a class="elsevierStyleCrossRef" href="#fig0004">Fig&#46; 4</a>A and C&#41;&#46; This suggests that cell migration was significantly decreased in sh-miR-223 cells when compared to that in sh-NC cells &#40;<a class="elsevierStyleCrossRef" href="#fig0004">Fig&#46; 4</a>B and D&#41;&#46; Based on these results&#44; the authors can assume that miRNA-223 upregulation reduced the invasion and migration ability of both EuSCs and EcSCs&#46;</p><elsevierMultimedia ident="fig0004"></elsevierMultimedia></span><span id="sec0019" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0027">Upregulation of miRNA-223 compromises cellular invasion ability</span><p id="para0026" class="elsevierStylePara elsevierViewall">Transwell assays compared the invasion ability of each of the cell groups&#46; High-magnification imaging of the transwell chamber showed that the number of EuSCs and EcSCs overexpressing miRNA-223 in the lower chamber were significantly reduced compared with those in the sh-NC group&#44; indicating that a decrease in miRNA-223 levels in the endometrial SCs from endometriosis patients reduced the migration and invasion ability of these cells &#40;<a class="elsevierStyleCrossRef" href="#fig0005">Fig&#46; 5</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span><span id="sec0019a" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0027a">miRNA-223 upregulation reduces cell proliferation</span><p id="para0028" class="elsevierStylePara elsevierViewall">Proliferation assay results revealed that the proliferation rate of sh-miR-223 cells was lower than that of the sh-NC cells for both EuSCs and EcSCs&#44; indicating that miRNA-223 upregulation may inhibit the proliferation of patient-derived endometrial SCs &#40;<a class="elsevierStyleCrossRef" href="#fig0006">Fig&#46; 6</a>&#41;&#46;</p><elsevierMultimedia ident="fig0006"></elsevierMultimedia></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0028">Upregulation of miRNA-223 promotes apoptosis</span><p id="para0029" class="elsevierStylePara elsevierViewall">The apoptosis rate of the EuSC sh-miR-223 cells &#40;<a class="elsevierStyleCrossRef" href="#fig0007">Fig&#46; 7</a>A&#41; was &#40;12&#46;04&#37; &#177; 1&#46;84&#37;&#41;&#44; whereas that of the sh-NC cells &#40;<a class="elsevierStyleCrossRef" href="#fig0007">Fig&#46; 7</a>B&#41; was &#40;4&#46;16&#37; &#177; 0&#46;84&#37;&#41;&#59; this difference was statistically significant &#40;p &#60; 0&#46;01&#41;&#46; The apoptosis rate of EcSC sh-miR-223 cells &#40;<a class="elsevierStyleCrossRef" href="#fig0007">Fig&#46; 7</a>C&#41; was &#40;15&#46;70&#37; &#177; 1&#46;25&#37;&#41; and was significantly higher than that of sh-NC cells &#40;<a class="elsevierStyleCrossRef" href="#fig0007">Fig&#46; 7</a>D&#41;&#44; which was &#40;5&#46;25&#37; &#177; 0&#46;74&#37;&#41; &#40;p &#60; 0&#46;01&#41;&#46; These results indicate that the upregulation of miRNA-223 expression promotes apoptosis in endometrial SCs from endometriosis patients&#46;</p><elsevierMultimedia ident="fig0007"></elsevierMultimedia></span></span><span id="sec0021" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0029">Discussion</span><p id="para0030" class="elsevierStylePara elsevierViewall">While endometriosis is a benign disease&#44; it is characterized by a wide range of pathological changes&#44; including increased invasion and aberrant growth of the endometrial tissues&#46; Further&#44; disease relapse is common&#46; Overall&#44; endometriosis has a serious impact on the bodily functions of patients&#44; severely compromising their daily life&#46; Thus&#44; this condition has become a major focus in obstetrics and gynecological research&#46; However&#44; the pathogenesis of endometriosis is complex and unclear&#44; with the classical theory being that of retrograde menstruation proposed by Sampson&#46;<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">10</span></a></p><p id="para0031" class="elsevierStylePara elsevierViewall">According to previous studies&#44; miRNA-223 is specifically expressed and involved in a variety of diseases&#46;<a class="elsevierStyleCrossRef" href="#bib0004"><span class="elsevierStyleSup">4</span></a> In particular&#44; miRNA-223 expression was shown to be upregulated in gastric<a class="elsevierStyleCrossRef" href="#bib0011"><span class="elsevierStyleSup">11</span></a> and ovarian cancer<a class="elsevierStyleCrossRef" href="#bib0012"><span class="elsevierStyleSup">12</span></a> and downregulated in the liver<a class="elsevierStyleCrossRef" href="#bib0013"><span class="elsevierStyleSup">13</span></a> and lung cancer&#46;<a class="elsevierStyleCrossRef" href="#bib0014"><span class="elsevierStyleSup">14</span></a> miRNA-223 has been reported to play a crucial role in the tumorigenesis&#44; development&#44; and metastasis of a number of malignancies and thus was also suggested as a diagnostic and prognostic biomarker in these pathologies&#46;<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">15</span></a> This study evaluated the expression of miRNA-223 in endometrial SCs from 26 patients with endometriosis and 14 hysteromyoma patients&#46; miRNA-223 was significantly downregulated in the endometrial SCs of endometriosis patients&#46;</p><p id="para0032" class="elsevierStylePara elsevierViewall">EMT is also involved in the pathogenesis of various diseases&#46; In normal tissues&#44; cells are arranged in tight&#44; ordered patterns&#59; in contrast&#44; tumor cells are loosely connected&#44; and their migration and invasion abilities are greatly enhanced&#46; The activation of EMT-related transcription factors leads to the inhibition of epithelial cell marker expression and an upregulation of SC markers&#46; This often results in the reduced expression of cell adhesion proteins &#40;such as E-cadherin&#41; as well as increased expression of cytokeratin and N-cadherin&#44; which reduce cell adhesion&#44;<a class="elsevierStyleCrossRef" href="#bib0016"><span class="elsevierStyleSup">16</span></a><span class="elsevierStyleSup">&#44;</span><a class="elsevierStyleCrossRef" href="#bib0017"><span class="elsevierStyleSup">17</span></a> improving the cell migration ability&#46;</p><p id="para0033" class="elsevierStylePara elsevierViewall">Vimentin is a structural protein that promotes cell migration<a class="elsevierStyleCrossRef" href="#bib0018"><span class="elsevierStyleSup">18</span></a> and Slug is a zinc-finger protein that regulates EMT mainly by suppressing E-cadherin&#46;<a class="elsevierStyleCrossRef" href="#bib0019"><span class="elsevierStyleSup">19</span></a> Overall&#44; EMT enhances the ability of cells to migrate and invade tissues&#46;<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">20</span></a> Studies have shown that miRNA-223 is involved in the regulation of EMT in certain diseases&#46; The present study&#39;s results reveal that the EMT-related molecules N-cadherin&#44; vimentin&#44; and Slug were suppressed in both EuSCs and EcSCs when the miRNA-223 expression was upregulated&#46; These observations indicate that miRNA-223 reversed EMT in SCs from endometriosis tissues&#46; Transwell and wound healing experiments confirmed that the migration and invasion abilities of these cells were significantly reduced&#44; indicating that miRNA-223 regulates EMT in endometriosis&#46; The specific mechanism underlying miRNA-223-mediated EMT regulation remains unclear&#46; A previous study&#44; in nasopharyngeal carcinoma&#44; reported that miRNA-223 functions as a tumor suppressor&#44; and its effects were primarily mediated via the downregulation of SSRP1 and inhibition of EMT&#46;<a class="elsevierStyleCrossRef" href="#bib0021"><span class="elsevierStyleSup">21</span></a> FBW7 was previously identified as a functional target of miRNA-223 in non-small cell lung cancer cells&#44; suggesting a critical role for the miR-223&#47;FBW7 pathway in regulating EMT and chemosensitivity&#46;<a class="elsevierStyleCrossRef" href="#bib0022"><span class="elsevierStyleSup">22</span></a></p><p id="para0034" class="elsevierStylePara elsevierViewall">In this study&#44; the authors found that the upregulation of miRNA-223 expression in EuSCs and EcSCs resulted in reduced cellular proliferation and enhanced apoptosis&#46; The mechanism underlying miRNA-223-mediated regulation of cellular proliferation and apoptosis is complex&#46; In colorectal cancer&#44; downregulating miR-223 expression enhanced FoxO3a and BIM expression&#44; suppressing SW620 cell proliferation and inducing apoptosis&#46;<a class="elsevierStyleCrossRef" href="#bib0023"><span class="elsevierStyleSup">23</span></a> In hepatocellular carcinoma&#44; miRNA-223 inhibited tumorigenesis and promoted apoptosis through the mTOR signaling pathway <span class="elsevierStyleItalic">in vitro</span>&#46;<a class="elsevierStyleCrossRef" href="#bib0024"><span class="elsevierStyleSup">24</span></a> In addition&#44; miRNA-223 inhibited proliferation and enhanced apoptosis in acute myeloid leukemia cell lines by directly targeting F-box and WD repeat domain containing 7&#46;<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">25</span></a></p><p id="para0035" class="elsevierStylePara elsevierViewall">In conclusion&#44; miRNA-223 expression was downregulated in endometrial SCs from endometriosis patients&#46; By upregulating miRNA-223 expression&#44; the expression of EMT-related molecules N-cadherin&#44; vimentin&#44; and Slug was suppressed in both EuSCs and EcSCs&#46; Upregulation of miRNA-223 expression also inhibited endometrial SC proliferation&#44; invasion&#44; and migration&#44; reversing the EMT&#46; Based on these results&#44; it is suggested that miRNA-223 is a potential therapeutic target for endometriosis&#46;</p></span><span id="sec0022" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0030">CRediT authorship contribution statement</span><p id="para0044" class="elsevierStylePara elsevierViewall"><span class="elsevierStyleBold">Yuan Xue&#58;</span> Conceptualization&#44; Data curation&#44; Formal analysis&#44; Methodology&#46; <span class="elsevierStyleBold">Xueyan Lin&#58;</span> Formal analysis&#44; Validation&#46; <span class="elsevierStyleBold">Tingting Shi&#58;</span> Formal analysis&#44; Validation&#46; <span class="elsevierStyleBold">Yongjie Tian&#58;</span> Conceptualization&#44; Data curation&#44; Formal analysis&#44; Funding acquisition&#44; Methodology&#44; Writing &#8211; original draft&#44; Writing &#8211; review &#38; editing&#46;</p></span><span id="sec0023" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0031">Funding</span><p id="para0045" class="elsevierStylePara elsevierViewall">This work was supported by the <span class="elsevierStyleGrantSponsor" id="gs0001">Natural Science Foundation of Shandong Province</span> &#40;grant number <span class="elsevierStyleGrantNumber" refid="gs0001">ZR2019MH129</span>&#41;&#46;</p></span></span>"
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      "resumen" => "<span id="abss0001" class="elsevierStyleSection elsevierViewall"><p id="spara008" class="elsevierStyleSimplePara elsevierViewall"><ul class="elsevierStyleList" id="celist0001"><li class="elsevierStyleListItem" id="celistitem0001"><span class="elsevierStyleLabel">&#8226;</span><p id="para0001" class="elsevierStylePara elsevierViewall">miRNA-223 was downregulated in endometrial stromal ells from endometriosis patients&#46;</p></li><li class="elsevierStyleListItem" id="celistitem0002"><span class="elsevierStyleLabel">&#8226;</span><p id="para0002" class="elsevierStylePara elsevierViewall">miRNA-223 upregulation repressed malignant behaviors of endometrial stromal cells&#46;</p></li><li class="elsevierStyleListItem" id="celistitem0003"><span class="elsevierStyleLabel">&#8226;</span><p id="para0003" class="elsevierStylePara elsevierViewall">miRNA-223 might serve as a potential therapeutic target for endometriosis&#46;</p></li></ul></p></span>"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abss0003" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0003">Objective</span><p id="spara009" class="elsevierStyleSimplePara elsevierViewall">This study was designed to evaluate the expression of microRNA-223 &#40;miRNA-223&#41; in patient-derived eutopic and ectopic endometrial stromal cells &#40;SCs&#41;&#46; Given the fact that miRNA-223 was previously shown to be upregulated in these cells and that this upregulation has been linked to epithelial-to-mesenchymal transition &#40;EMT&#41; during endometriosis&#44; this study aimed to further explore the expression of miRNA-223&#44; its effect in endometriosis&#44; and the mechanisms underlying its effects&#46;</p></span> <span id="abss0004" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0004">Methods</span><p id="spara010" class="elsevierStyleSimplePara elsevierViewall">Endometrial tissue was collected from 26 patients with endometriosis and 14 patients with hysteromyoma &#40;control group&#41;&#46; Primary endometrial SCs were isolated and cultured from several endometrial samples and miRNA-223 expression was evaluated using qRT-PCR&#46; Cells were then transfected with a miRNA-223 overexpression lentiviral vector &#40;sh-miR-223 cells&#41; or an empty control &#40;sh-NC cells&#41; and then used to monitor the effects of miRNA-223 on the expression of several EMT-associated proteins&#44; including N-cadherin&#44; vimentin&#44; and Slug&#44; using western blot&#46; Cellular migration&#44; invasion&#44; and proliferation were then evaluated using a wound healing&#44; Transwell&#44; and CCK-8 assay&#44; respectively&#46; Flow cytometry was used to detect apoptosis&#46;</p></span> <span id="abss0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0005">Results</span><p id="spara011" class="elsevierStyleSimplePara elsevierViewall">There was a significant decrease in the expression of miRNA-223 in both eutopic and ectopic endometrial SCs &#40;p &#60; 0&#46;05&#41; whereas upregulation of miRNA-223 inhibited the expression of EMT-related molecules and reduced cell migration&#44; invasion&#44; and proliferation&#46; High levels of miRNA-223 also promoted apoptosis&#46;</p></span> <span id="abss0006" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0006">Conclusion</span><p id="spara012" class="elsevierStyleSimplePara elsevierViewall">miRNA-223 expression decreased in endometrial SCs from endometriosis patients&#44; which may facilitate the differential regulation of EMT during endometriosis&#46;</p></span> <span id="abss0007" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="cesectitle0007">Clinical Trial registration number</span><p id="spara013" class="elsevierStyleSimplePara elsevierViewall">SWYX2020-211&#46;</p></span>"
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            "etiqueta" => "Appendix"
            "titulo" => "Supplementary materials"
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          "en" => "<p id="spara001" class="elsevierStyleSimplePara elsevierViewall">Relative expression of miRNA-223 in control cells&#44; EuSCs&#44; and EcSCs&#46; Expression level of miRNA-223 in EuSCs and EcSCs were significantly lower than those in the control group&#46; miRNA-223&#44; microRNA-223&#59; EuSCs&#44; eutopic endometrial stromal cells&#59; EcSCs&#44; ectopic endometrial stromal cells&#59; &#42;p &#60; 0&#46;05&#44; when compared with the control cells&#46;</p>"
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
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                        "tituloSerie" => "BMC Womens Health"
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                          "etal" => false
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                            0 => "PD Zamore"
                            1 => "B&#46; Haley"
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                    0 => array:2 [
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                0 => array:2 [
                  "contribucion" => array:1 [
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                      "titulo" => "miR-223&#58; infection&#44; inflammation and cancer"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:4 [
                            0 => "M Haneklaus"
                            1 => "M Gerlic"
                            2 => "LA O&#39;Neill"
                            3 => "SL&#46; Masters"
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                      "doi" => "10.1111/joim.12099"
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                        "volumen" => "274"
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                      "titulo" => "MicroRNA-regulated pathways associated with endometriosis"
                      "autores" => array:1 [
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                            1 => "KH Van der Hoek"
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Article information
ISSN: 18075932
Original language: English
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