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Department of Gynecology and Obstetrics (K.F., H.Fujiw., B.-X.Z., H.Fujii, S.Y.), and Molecular Pathology Unit (E.N.), Horizontal Medical Research Organization, and Department of Integrative Brain Science (T.N.), Faculty of Medicine, Kyoto University, Kyoto 606-8507, Japan; and Department of Obstetrics and Gynecology (Y.S.), Osaka National Hospital, Osaka 540-0026, Japan
Address all correspondence and requests for reprints to: Hiroshi Fujiwara, M.D., Department of Gynecology and Obstetrics, Faculty of Medicine, Kyoto University, Sakyo-ku, Kyoto 606-8507, Japan. E-mail: fuji{at}kuhp.kyoto-u.ac.jp.
| Abstract |
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| Introduction |
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Just before follicular rupture, granulosa cells in the follicular fluid, which contains anticoagulant substances (1), proceed to luteinization and shift their main products from estrogen to progesterone. After ovulation, these granulosa cells undergo hypertrophy to differentiate into large luteal cells, being in contact with migrating endothelial cells (2) and producing extracellular matrix (ECM) around the luteal cells (3, 4, 5).
Dramatic centripetal angiogenesis also occurs from the vascular network surrounding the follicle, although follicular fluid contains antiangiogenetic factors (6). During ovulation, the follicular basement membrane is destroyed and endothelial cells just outside the membrane migrate into the inner granulosa cell layer. In the human CL, it takes several days to complete mature vascular networks among the luteal cells (2), finally achieving vascular anastomosis in the central cavity area, which is the luteal remnant of the antral cavity of a ruptured follicle.
To induce neovascularization, luteinizing granulosa cells have been proposed to secrete several soluble angiogenic factors such as vascular endothelial growth factor (VEGF), angiogenin, endocrine gland-VEGF, and angiopoietin (7, 8, 9, 10). Luteinizing theca cells were also proposed to play some role in angiogenesis in human CL (11). In addition, we previously reported that luteinizing granulosa cells increased the cell surface expression of ephrin B1 and melanoma cell adhesion molecule (MCAM), which are reported to regulate endothelial migration and vessel formation by cell-to-cell contact (12, 13, 14). Furthermore, ECM produced by luteinizing granulosa cells is considered to modulate the migration and outgrowth of endothelial cells (15). However, there is no definite evidence demonstrating that there is local dominance of angiogenic factors in the central cavity to maintain endothelial migration toward the area until final the anastomosis is achieved. Thus, the precise mechanisms by which centripetal vascular development is regulated remain unknown.
During ovulation, a decrease of vascular stability beneath the follicular basement membrane is evident, and consequently blood cells migrate into extravascular spaces around luteinizing granulosa cells (2, 16). In addition, blood vessels begin to penetrate into the granulosa cell layer and some vessels open into the antral cavity, filling it with blood (17). Accordingly, fresh bleeding toward the central cavity is often observed for 4 d in CL in the early stage (2, 18). Thus, blood plasma fluid and blood cells, including red cells, normally flow among luteinizing granulosa cells that are surrounded by ECM in the extravascular spaces (2, 16), and the CL in this stage is occasionally called the corpus rubrum. However, the fibrin net was mainly observed in the central cavity area, and only sparsely among luteinizing granulosa cells (2), theoretically suggesting that there is some anticoagulant system(s) operating around granulosa cells. This condition is considered essential for maintaining the local circulation of tissue fluid throughout fresh CL and recruiting this progesterone-containing tissue fluid into the systemic circulation. However, very little attention has been given to this paradoxical issue, and it remains unclear how the dynamic kinetics of tissue fluid are controlled, regulating the coagulation systems throughout the process of corpus luteum formation until the establishment of a viable vascular network.
Together with red blood cells, platelets, which are a type of blood cells that plays an important role in coagulant systems, are likely to be exuded into extravascular spaces among luteinizing granulosa cells. Recently platelets were reported to contain chemoattractive substances potentially capable of inducing endothelial migration (19) and to play an important role in pathological processes such as atherosclerosis, wound healing, and tissue remodeling (20, 21). Therefore, we examined the precise spatiotemporal distribution of platelets in human CL and estimated their possible roles in CL formation, which is one of the dynamic and physiological phenomena involving in tissue remodeling.
| Materials and Methods |
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IIb/CD41 (clone M148) and thrombomodulin/CD141 (clone 1009) monoclonal antibodies (mAbs) were obtained from Novocastra Laboratories Ltd. (Newcastle, UK). Fluorescein isothiocyanate (FITC)-conjugated mouse antihuman CD41 mAb (clone M148) was purchased from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA). The mouse antihuman P-selectin/CD62P (clone AK-4) mAb was obtained from BD Biosciences-PharMingen (Tokyo, Japan). The mouse antihuman collagen type IV (clone IV-3A9) mAb and antihuman fibronectin (clone 9621F2) mAb were purchased from Daiichi Fine Chemical (Takaoka, Japan), and antihuman fibrin mAb (clone E8) was obtained from Chemicon (Temecula, CA). Antihuman 3ß-hydroxysteroid dehydrogenase rabbit polyclonal antibody (pAb) was purchased from Oxygene (Dallas, TX). FITC-conjugated and nonconjugated mouse IgG1 (clone DAK-GO1) and IgG2b (clone DAK-GO9) mAbs and rabbit Ig for negative controls were all obtained from Dako (Glostrup, Denmark). For the secondary antibody, FITC-conjugated rabbit antimouse Ig pAb (Dako), FITC-conjugated swine antirabbit Ig pAb (Dako) and rhodamine-conjugated goat antimouse Ig pAb (Santa Cruz) were used. The mouse antihuman MCAM (clone S-Endo1; Alexis Biochemicals, San Diego, CA) and antihuman integrin
5 (clone SAM-1; Chemicon) mAbs were used for flow cytometry.
Tissues
CL of the early (CL d 25, n = 17) and midluteal (CL d 78, n = 5) phases were obtained from 22 women, aged between 25 and 43 yr. All women had undergone unilateral ovarian cystectomy or oophorectomy and contralateral wedge resection to treat benign ovarian tumors. All of the women had a history of regular menstrual cycles (2830 d), and their ovulatory basal body temperature charts were consistent with normal luteal phase length. No patient used contraceptives or GnRH analogs within at least 3 months before the operation. The CL day was reevaluated according to histological dating, using hematoxylin and eosin-stained tissue sections that were fixed with 10% formalin and embedded in paraffin (2). The migration of endothelial cells and the size of luteal cells were used for this classification. In the present study, the term CL day was used according to this definition. For example, CL d 2 was the day after ovulation, which was confirmed by transvaginal ultrasonography and histological dating. Informed consent for the use of these tissues was obtained from each donor. Use of the materials was also approved by the Ethics Committee of Kyoto University Hospital.
Immunohistochemistry
Double-immunofluorescence staining was performed as previously described (22, 23). Frozen tissues were sliced to 7-µm thickness using a cryostat microtome (Cryocut 1800; Reichert-Jung, Heidelberg, Germany), immediately air dried on Neoplene (Nisshin EM, Tokyo, Japan)-coated glass slides, and fixed in acetone at 20 C for 5 min. The frozen sections were incubated with antihuman collagen type IV mAb [5 µg/ml, diluted in culture medium containing 10% fetal calf serum (FCS; Equitech-Bio, Inc., Kerrville, TX) and 0.1% NaN3], antihuman fibronectin mAb (5 µg/ml), antihuman fibrin mAb (5 µg/ml), antihuman CD41 mAb (5 µg/ml), antihuman CD62p mAb (5 µg/ml), or mouse negative control IgG1 (5 µg/ml). After the slides were washed in PBS, they were incubated with rhodamine-conjugated goat antimouse immunoglobulin. The washed slides were blocked with mouse anti-TNP (trinitrophenyl) mAb (unrelated mAb; 20 µg/ml) and then incubated with FITC-conjugated antihuman integrin
IIb/CD41 mAb (10 µg/ml). Otherwise, for secondary staining, the washed slides were incubated with antihuman 3ß-hydroxysteroid dehydrogenase rabbit pAb (10 µg/ml) or control rabbit Ig (10 µg/ml), followed by FITC-conjugated swine antirabbit Ig. The slides were washed, mounted with a mounting agent (Perma Fluor aqueous mounting medium; Immunon, Pittsburgh, PA), and examined under a confocal laser-scanning microscope (Carl Zeiss Inc., Jena, Germany).
Isolation of human luteinizing granulosa cells, platelets, and umbilical vein epithelial cells (HUVECs)
Fresh human luteinizing granulosa cells were obtained from 38 patients aged from 25 to 39 yr who had undergone treatment for in vitro fertilization (IVF) as previously described (3). Human platelets were also isolated from patients undergoing IVF treatment as described (23, 24). Whole blood was obtained from patients undergoing IVF treatment, immediately mixed with 3.8% (vol/wt) trisodium citrate dihydrate (ratio of blood to citrate was 9:1) in polypropylene tubes, and centrifuged at 200 x g for 15 min at 22 C. The platelet-rich plasma was centrifuged after adding a mixture of 4.5% wt/volcitric acid and 6.6% wt/voldextrose at 50 µl/ml platelet-rich plasma. The sedimented platelets were resuspended in RPMI 1640 containing 5.4 mM EDTA, stabilized for 10 min at room temperature, centrifuged at 980 x g for 10 min at 22 C, and then was suspended in RPMI 1640 (2 x 108/ml).
HUVECs were separated from the umbilical cord as described previously (25). After washing the inner wall of the umbilical vein with PBS to remove fetal blood, the lumen was filled with PBS containing Ca2+ and Mg2+ as well as 0.05% collagenase (Wako Pure Chemical Industries Ltd., Osaka, Japan) and incubated for 30 min at room temperature. After the detached cells were collected, the remaining endothelial cells in the inner layer of the umbilical vein were collected by further washing with RPMI 1640 containing 15% FCS. The isolated HUVECs were cultured using HuMedia-EB2 (Kurabo, Osaka, Japan) containing 2% FCS, human epithelial growth factor (10 ng/ml), hydrocortisone (1 µg/ml), human basic fibroblast growth factor (3 ng/ml), and heparin (10 µg/ml) as well as gentamicin (50 mg/ml) and amphotericin B (50 µg/ml). Immunocytochemical staining using anti-CD141/thrombomodulin mAb confirmed the greater than 95% purity of endothelial cells in the above preparation.
Informed consent for the use of granulosa cells, platelets and HUVECs in this study was obtained from all donors. Use of the materials was also approved by the Ethics Committee of Kyoto University Hospital.
Luteinizing granulosa cell culture with platelets
Isolated human granulosa cells were resuspended in culture medium consisting of RPMI 1640 medium supplemented with 10% FCS. These cells (1 x 105 cells/ml /well) were cultured in each well of 24-well plates (Becton Dickinson, Lincoln Park, NJ) in triplicate in the presence or absence of recombinant human chorionic gonadotropin (HCG) (5 IU/ml; Rhoto Pharmaceutical Co. Ltd., Osaka, Japan) and isolated platelets (2 x 107 and 2 x 108 cells/ml). Granulosa cells were also incubated with platelets (2 x 108 cells/ml) in 0.45-µm-pore culture chambers (Intercell, Kurabo Co. Ltd., Osaka, Japan), which prevented direct contact between granulosa cells and platelets. The culture medium was gently replaced with fresh medium every 2 d, and the collected medium was subjected to a RIA. Morphological changes were observed under a phase-contrast microscope and recorded using a digital camera (Camedia C5050; Olympus, Tokyo, Japan). The average length to width ratio of 30 cells in each well and the mean values of triplicate wells were calculated. The cell circumference and size (area) were calculated using National Institutes of Health Image 1.63 (n = 5).
Assay of progesterone in culture media
The concentrations of progesterone in the culture medium were measured using RIA kits (Immunotech, Marseille, France). Inter- and intraassay coefficients of variation were 5.7 and 5.3%, respectively.
Matrigel invasion assay
The invasion assay was carried out as previously described (26). A 6.4-mm-diameter culture insert with an 8-µm-pore membrane filter (Becton Dickinson) was placed in collagen type I-coated 24-well plates (Asahi Techno Glass, Tokyo, Japan). The upper surface of the membrane filter was precoated with diluted Matrigel (Becton Dickinson; 300 µg/ml). The lower well was filled with 700 µl RPMI 1640 (1% FCS) with or without (control) platelets (2 x 108 cells/well) and/or granulosa cells (1 x 105 cells/well) in the presence or absence of HCG (5 U/ml). Then isolated HUVECs (2.5 x 105 cells per 300 µl of RPMI 1640 with 1% FCS) were inoculated into the upper chamber. After a 3-h incubation at 37 C, HUVECs that reached the lower surface were fixed with 100% methanol at 20 C for 5 min and were FITC stained using anti-CD141 mAb. The stained filters were examined under a confocal laser-scanning microscope and the numbers of CD141-positive cells were counted for quantification using National Institutes of Health Image 1.63 (26). These experiments were performed in triplicate (n = 7), and the average was defined as the invading cell number. Each result was expressed as the percentage of invading cell numbers found in the control (without coculture or additives).
Proliferation assay
HUVECs were cultured in the intercell chambers for 48 h in the presence or absence of granulosa cells (1 x 105 cells/well), HCG (5 U/ml), and/or platelets (1 x 108 cells/well). The number of HUVECs in each intercell chamber was assessed using the Premix WST-1 cell proliferation assay system (Takara, Kusatsu, Japan) and ELISA plate reader (Molecular Device, Menlo Park, CA) according to the manufacturers instructions.
Flow cytometry
Flow cytometry was performed as described previously (3). Detached granulosa cells (n = 5) cultured with or without HCG (5 U/ml) or platelets (1 x 108 cells/ml) were reacted with antihuman MCAM, integrin
5, or control mAb (100 µg/ml, 10 µl) and then with FITC-conjugated rabbit pAb. Cell surface labeling was analyzed using a FACScalibur (Becton Dickinson).
Statistics
Data are shown as means ± SEM. The concentration of progesterone in the culture medium, average length to width ratio, cell circumference and size of cultured luteinizing granulosa cells, cell numbers of HUVECs, and the mean intensity in flow cytometry were analyzed by ANOVA, followed by Scheffés F test for multiple comparison. The difference was considered significant at P < 0.05.
| Results |
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In the CL on d 5 (n = 4), granulosa cell luteinization proceeded further, and small luteal cells could be distinguished from large luteal cells (Fig. 1K
). Extravascular blood lakes that contained degenerative materials were sparsely observed among large luteal cells (Fig. 1L
). In this stage, platelet deposition was almost limited to within the central cavity (Fig. 3
, E and F).
In the CL on d 78 (n = 5), vascular networks had been established (Fig. 2E
), and vascular anastomosis in the central cavity was observed (Fig. 2F
). In this stage, there were few extravascular blood lakes and no platelet deposition among large luteal cells or in extravascular spaces was observed (Fig. 3G
).
In the CL on d 3, CD 41-positive platelets were deposited in the ECM showing fibronectin and collagen type IV around luteinizing granulosa cells (Fig. 3H
). In the CL on d 4, a fibrin net was mainly observed in the central cavity but was sparsely detected among luteinizing granulosa cells, as described previously (Fig. 3I
) (2). In the CL on d 5, thrombomodulin/CD141-positive endothelial cells were observed to migrate through the luteinizing granulosa cell layer into the central cavity, forming vascular anastomoses (Fig. 3
, J and K). Platelets that were deposited in the central region expressed P-selectin/CD62P (Fig. 3
, L and M), showing that these platelets were activated.
The effects of platelets on the morphology of luteinizing granulosa cells
In the presence of HCG, granulosa cells became round or oval, a change that resembles luteal cell transformation, whereas in the presence of platelets, spreading of luteinizing granulosa cells was enhanced during 48 h of culture (Fig. 4
, AC). Supporting this observation, both the calculated cell areas and circumferences of cultured granulosa cells were significantly reduced by HCG, whereas these parameters were promoted by platelets (Fig. 4
, E and F), indicating that there are functional differences between HCG and platelets in the effects on the morphological changes of luteinizing granulosa cells. Under conditions of direct contact with platelets, similar microscopic morphological changes were induced in luteinizing granulosa cells (Fig. 4D
). Flow cytometry showed that the expression levels of MCAM and integrin
5 cell surface markers for luteinization, on granulosa cells were increased by HCG, as described previously (4, 14), but not by platelets (Fig. 4
, G and H).
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In cocultures with platelets, the number of migrated HUVECs was significantly enhanced (Fig. 6A
). However, luteinizing granulosa cells, which had been reported to produce angiogenic factors, showed little effect on HUVEC migration, even with stimulation by HCG. Unexpectedly, the enhancing effect of platelets was attenuated by luteinizing granulosa cells.
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| Discussion |
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To investigate the physiological role of platelets in the luteinization of granulosa cells, we examined the effects of platelets on progesterone production by cultured luteinizing granulosa cells. In the presence of HCG, progesterone production was significantly enhanced during 4-d culture. Notably, coculture with platelets also promoted progesterone production by granulosa cells, suggesting that platelets facilitate luteinization of granulosa cells.
This study also showed that coculturing with platelets induced marked spreading of granulosa cell morphology, suggesting that platelets enhanced the adhesive property of granulosa cells. Previously we reported that luteinizing granulosa cells showed increased expression of MCAM (14), which was reported to regulate cell attachment to endothelial cells (13), and integrin
5, which is a receptor for fibronectin (4). Although HCG enhances the expression of these molecules, there was no significant change in MCAM or integrin
5 expression by coculturing with platelets in this study. Thus, although the increase in size induced by platelets is compatible with the morphological change during the luteinization process, the mechanism may differ from that induced by HCG. In contrast to their effects on progesterone production, morphological changes elicited by platelets did not require direct contact with granulosa cells, suggesting that platelets affect granulosa cell luteinization through more than a single pathway.
For more than a decade, the contribution of white blood cells to CL function has been proposed (28). However, there has not been any report concerning the direct effects of platelets on human luteal function. Although this study did not provide precise information about the mechanism by which platelets promote progesterone production, it can be proposed that platelets are novel local regulators of the luteinization of human granulosa cells.
Then we examined the effects of platelets on endothelial cell migration using HUVECs and a Matrigel invasion assay. In the human early CL, it was reported that angiogenic factors such as VEGF and endocrine gland-VEGF were produced by luteinizing granulosa cells, and their production was promoted by LH/HCG stimulation (29, 30). Although these factors were proposed to contribute to endothelial cell proliferation and maintenance of the vascular structure in human CL, there is no evidence showing that granulosa cells enhance endothelial cell migration. In this study, endothelial cell migration was not enhanced by granulosa cells. Even in the presence of HCG, there was no significant effect on endothelial migration. However, when platelets were cocultured with endothelial cells, endothelial cell migration was promoted (31). Although there are some functional differences between endothelial cells in umbilical veins and ovulating follicles (32), these findings suggest that platelets are more potent stimulators of endothelial cell migration than luteinizing granulosa cells.
Platelets contain several factors such as VEGF and sphingosine 1-phosphate, which may contribution to vascular extension (33). When cocultured with platelets, granulosa cells unexpectedly showed inhibition of endothelial cell migration induced by platelets in the presence or absence of HCG. These findings may be accorded with a recent report that culturing of HUVECs with conditioned medium from cultured human luteinized granulosa cells lead to the expression of antiangiogenic factors at the transcript level in endothelial cells (6). To achieve fine and mature vascular networks among fully luteinized luteal cells, the processes of vascularization and luteinization as well as the arrangement of ECM should be synchronized. These findings may reflect a crucial role of granulosa cells in regulating adequate neovascularization by protecting against excessive stimulatory effects of platelets on endothelial migration.
Ovulation and subsequent corpus luteum formation are considered to mimic an inflammatory reaction (34). Accumulating evidence shows that there is a cross-talk between inflammation and coagulation systems (35), whereby inflammation not only leads to the activation of coagulation, but coagulation also considerably affects inflammatory activity (36). This inflammatory reaction is also considered to elicit cell migration and proliferation in cooperation with the coagulation system (35). This study provides further evidence that platelets, which are the main contributors to the coagulation system, induce cell differentiation and migration in the tissue remodeling process in the adult human ovary.
In conclusion, this study showed that the extravascular localization of platelets accords with the neovascularization process during human CL formation. The direct interaction of platelets with granulosa cells was demonstrated to promote progesterone production by granulosa cells. In addition, platelet-derived soluble factors induced morphological changes in granulosa cells, suggesting that platelets are involved in the process of differentiation of human granulosa cells toward large luteal cells. Furthermore, platelet-derived soluble factors were shown to be a greater stimulant of endothelial migration than granulosa cells. Although it remains unknown how the coagulation system is controlled to maintain adequate kinetics of tissue fluid among luteinizing granulosa cells, the present results lead us to propose a novel concept whereby platelets regulate spatiotemporal construction of vascular networks in the early human CL (Fig. 7
). These findings also support the recent concept that platelets play an important role in wound healing processes and will contribute to clarifying the mechanism of extravascular circulation in inflammatory lesions.
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| Acknowledgments |
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| Footnotes |
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Disclosure Statement: The authors have nothing to disclose.
First Published Online April 19, 2007
Abbreviations: CL, Corpus luteum; ECM, extracellular matrix; FCS, fetal calf serum; FITC, fluorescein isothiocyanate; HCG, human chorionic gonadotropin; HUVEC, human umbilical vein epithelial cell; IVF, in vitro fertilization; mAb, monoclonal antibody; MCAM, melanoma cell adhesion molecule; pAb, polyclonal antibody; VEGF, vascular endothelial growth factor.
Received December 15, 2006.
Accepted for publication April 9, 2007.
| References |
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6ß1. J Clin Endocrinol Metab 82:21222128
5 is expressed on human luteinizing granulosa cells during corpus luteum formation, and its expression is enhanced by human chorionic gonadotrophin in vitro. Mol Hum Reprod 3:979984
2 and collagen type IV: possible involvement of collagen type IV in granulosa cell luteinization. Mol Hum Reprod 5:607617
. Mol Hum Reprod 9:311319
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