Disordered IL-33/ST2 activation in decidualizing stromal cells prolongs uterine receptivity in women with recurrent pregnancy loss

PLoS One. 2012;7(12):e52252. doi: 10.1371/journal.pone.0052252. Epub 2012 Dec 27.

Abstract

Decidualization renders the endometrium transiently receptive to an implanting blastocyst although the underlying mechanisms remain incompletely understood. Here we show that human endometrial stromal cells (HESCs) rapidly release IL-33, a key regulator of innate immune responses, upon decidualization. In parallel, differentiating HESCs upregulate the IL-33 transmembrane receptor ST2L and other pro-inflammatory mediators before mounting a profound anti-inflammatory response that includes downregulation of ST2L and increased expression of the soluble decoy receptor sST2. We demonstrate that HESCs secrete factors permissive of embryo implantation in mice only during the pro-inflammatory phase of the decidual process. IL-33 knockdown in undifferentiated HESCs was sufficient to abrogate this pro-inflammatory decidual response. Further, sequential activation of the IL-33/ST2L/sST2 axis was disordered in decidualizing HESCs from women with recurrent pregnancy loss. Signals from these cultures prolonged the implantation window but also caused subsequent pregnancy failure in mice. Thus, Il-33/ST2 activation in HESCS drives an autoinflammatory response that controls the temporal expression of receptivity genes. Failure to constrain this response predisposes to miscarriage by allowing out-of-phase implantation in an unsupportive uterine environment.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Habitual / metabolism
  • Abortion, Habitual / pathology*
  • Abortion, Habitual / physiopathology*
  • Animals
  • Autocrine Communication
  • Cell Differentiation*
  • Decidua / cytology
  • Decidua / pathology*
  • Decidua / physiology
  • Decidua / physiopathology
  • Embryo Implantation*
  • Female
  • Gene Expression Regulation
  • Humans
  • Interleukin-1 Receptor-Like 1 Protein
  • Interleukin-33
  • Interleukins / metabolism*
  • Mice
  • Mice, Inbred C57BL
  • Pregnancy
  • Receptors, Cell Surface / chemistry
  • Receptors, Cell Surface / metabolism*
  • Solubility
  • Stromal Cells / cytology
  • Stromal Cells / metabolism
  • Stromal Cells / pathology
  • Time Factors

Substances

  • IL1RL1 protein, human
  • IL33 protein, human
  • Interleukin-1 Receptor-Like 1 Protein
  • Interleukin-33
  • Interleukins
  • Receptors, Cell Surface

Grants and funding

This work was supported the Biomedical Research Unit in Reproductive Health, a joint initiative between the University Hospitals Coventry and Warwickshire National Health Service Trust and Warwick Medical School, and the Genesis Research Trust (MSS). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.