Endometrial claudin-4 and leukemia inhibitory factor are associated with assisted reproduction outcome
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BioMed Central
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Endometrial claudin-4 and leukemia inhibitory factor are associated with assisted reproduction outcome Paulo C Serafini*†1,2, Ismael DCG Silva3, Gary D Smith4, Eduardo LA Motta2,3, André M Rocha2 and Edmund C Baracat†1 Address: 1Department of Gynecology, Faculdade de Medicina, Universidade de São Paulo, São Paulo, Brazil, 2Huntington Reproductive Medicine, São Paulo, Brazil, 3Department of Gynecology, Universidade Federal de São Paulo, São Paulo, Brazil and 4Department of Obstetrics and Gynecology, Urology, Physiology, and Reproductive Science Program, University of Michigan, Ann Arbor, USA Email: Paulo C Serafini* - [email protected]; Ismael DCG Silva - [email protected]; Gary D Smith - [email protected]; Eduardo LA Motta - [email protected]; André M Rocha - [email protected]; Edmund C Baracat - [email protected] * Corresponding author †Equal contributors
Published: 19 April 2009 Reproductive Biology and Endocrinology 2009, 7:30
doi:10.1186/1477-7827-7-30
Received: 4 December 2008 Accepted: 19 April 2009
This article is available from: http://www.rbej.com/content/7/1/30 © 2009 Serafini et al; licensee BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract Background: Claudin-4 (CLDN4) is one of several proteins that act as molecular mediators of embryo implantation. Recently, we examined immunolabeling of leukemia inhibitory factor (LIF) in the endometrial tissue of 52 IVF patients, and found that LIF staining intensity was strongly correlated with successful pregnancy initiation. In the same set of patients, we have now examined endometrial CLDN4 expression, to see how expression intensity may vary with LIF. We examined CLDN4 in the luteal phase of the menstrual cycle, immediately preceding IVF treatment. Our aim was to compare expression of LIF and CLDN4 in the luteal phase, and document these patterns as putative biomarkers for pregnancy. Methods: Endometrial tissue was collected from women undergoing IVF. Endometrial biopsies were obtained during the luteal phase preceding IVF, and were then used for tissue microarray (TMA) immunolabeling of CLDN4. Previously published LIF expression data were then combined with CLDN4 expression data, to determine CLDN4/LIF expression patterns. Associations between successful pregnancy after IVF and combined CLDN4/LIF expression patterns were evaluated. Results: Four patterns of immunolabeling were observed in the endometrial samples: 16% showed weak CLDN4 and strong LIF (CLDN4-/LIF+); 20% showed strong CLDN4 and strong LIF (LIF+/ CLDN4+); 28% showed strong CLDN4 and weak LIF (CLDN4+/LIF-); and 36% showed weak CLDN4 and weak LIF (CLDN4-/LIF-). Successful implantation after IVF was associated with CLDN4-/LIF+(p = 0.003). Patients showing this endometrial CLDN4-/LI
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