Tissue Factor Positive Extracellular Vesicles Identified in Women with Endometriosis. Possible Risk of Cardiovascular Disease and Stroke
by Graciela Krikun1*, Abdullah Ucar1, E. Cansu Cevik1, Nigel Mackman2
*1YALE School of Medicine, Department of OB-GYN and reproductive sciences, USA
2University of North Carolina Department of Medicine at Chapel Hill NC 27599, USA
*Corresponding author: Graciela Krikun, YALE School of Medicine, Department of OB-GYN and Reproductive Sciences, USA.
Received Date: 7 August 2024
Accepted Date: 13 August 2024
Published Date: 15 August 2024
Citation: Krikun G, Ucar A, Cevik E C, Mackman N (2024) Tissue factor positive extracellular vesicles identified in women with endometriosis. Possible risk of cardiovascular disease and stroke. Gynecol Obstet Open Acc 8: 211. https://doi.org/10.29011/2577-2236.100211
Abstract
Endometriosis is a common hormone-responsive disease defined by the ectopic growth of uterine endometrium that can cause pain and/or infertility and depression, which reduces women’s quality of life [1] [2]. The pathogenesis of endometriosis is likely multifactorial, and extensive investigation has explored the role of genetics, environmental factors, and the aberrant function of the immune system. In the current study, we have identified extracellular vesicles (EVs) from cultured endometrial stromal cells derived from control human endometrial stromal (HESC) cell lines and from endometriosis-derived HESC as well as from plasma-derived EVs from women with endometriosis compared with controls.
We found that some women with endometriosis have a higher level of EV TF activity in plasma which could contribute to cardiac disorders and stroke. We have previously reported a marked elevation of TF expression in eutopic, or ectopic endometrium derived from women with this disease compared to controls [3].
Several studies have identified a correlation of endometriosis, cardiovascular disease and stroke [4] [5] [6]. In the current study, we demonstrate that tissue factor (TF), the initiator of coagulation and known to play a role in angiogenesis, is more highly expressed in cells and plasma from women with endometriosis and its activated form is identified in extracellular vesicles (EVs) from women with disease vs. controls. EVs are broadly classified into exosomes, microvesicles and apoptotic bodies according to their size and sub-cellular origin [7]. These are nanometer-sized vesicles that form by budding of the cell membrane and contains endoplasmic reticulum-derived materials. They carry various components of the cytoplasm and cell membrane derived from their parental cells that are selectively loaded into these vesicles [8]. EVs are secreted by all forms of living cells and play essential roles in different physiological functions and pathological processes [9], such as cancers. Based on our findings, we propose these TF positive EVs (TF+ EVs) may contribute to cardiac disease and stroke in women with endometriosis.