Key result
Recurrent implantation failure with high uterine arterial impedance is linked to reduced ANGPTL4 and PPARγ.
Why the study?
Is decreased endometrial and serum ANGPTL4 associated with impaired endometrial angiogenesis and decidualization in women with recurrent implantation failure and elevated uterine arterial impedance, and does rosiglitazone up-regulate ANGPTL4 via PPARγ?
Case-Control (n=36)
No
Is decreased endometrial and serum ANGPTL4 associated with impaired endometrial angiogenesis and decidualization in women with recurrent implantation failure and elevated uterine arterial impedance, and does rosiglitazone up-regulate ANGPTL4 via PPARγ?
Decreased endometrial and serum ANGPTL4 is associated with impaired decidualization and angiogenesis in women with recurrent implantation failure and elevated uterine arterial impedance, and PPARγ activation by rosiglitazone restores ANGPTL4 expression and endothelial angiogenesis in vitro.
Answers are grounded in this paper and cite their sources.
Should not yet change practice in recurrent implantation failure; leaves open whether PPARγ activation enhances endometrial receptivity.
Insufficient endometrial angiogenesis during peri-implantation impairs endometrial receptivity (ER), which contributes to recurrent implantation failure (RIF) during in vitro fertilization and embryo transfer (IVF-ET). Angiopoietin-like protein 4 (ANGPTL4) acts as a multifunctional secretory protein and is involved in the regulation of lipid metabolism and angiogenesis in various tissues including the endometrium. Herein, we found decreased ANGPTL4 expression in endometrial tissue and serum during peri-implantation period in 18 RIF-affected women with elevated uterine arterial impedance (UAI) compared with the pregnancy controls. ANGPTL4 and peroxisome proliferator-activated receptor gamma (PPARγ) expression were up-regulated upon decidualization on human endometrial stromal cells (HESCs). Rosiglitazone promoted the expression of ANGPTL4 in HESCs and human umbilical vein endothelial cells (HUVECs) via PPARγ. ANGPTL4 promoted the proliferation, migration and angiogenesis of HUVECs in vitro. Our results suggest that decreased abundance of ANGPTL4 in endometrial tissues impairs the endometrial receptivity via restraining endometrial angiogenesis during decidualization; while rosiglitazone-induced ANGPTL4 up-regulation in hESCs and HUVECs through PPARγ. Therefore, ANGPTL4 could be a potential therapeutic approach for some RIF-affected women with elevated UAI.
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Li et al. (2020) conducted a case-control in Recurrent implantation failure (RIF) with elevated uterine arterial impedance (UAI) (n=36). Recurrent implantation failure with elevated uterine arterial impedance (human study) / Rosiglitazone and rhANGPTL4 (in vitro) vs. Control patients who achieved clinical pregnancy following endometrial biopsy collection (n=18) was evaluated on Endometrial and serum ANGPTL4 and PPARγ expression during peri-implantation period (Day LH+7) (p=<0.05). ANGPTL4 and PPARγ expression in peri-implantation endometrium and serum were significantly reduced in women with recurrent implantation failure and elevated uterine arterial impedance (p<0.05).
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