Dienogest inhibits aromatase and cyclooxygenase-2 expression and prostaglandin E2 production in human endometriotic stromal cells in spheroid culture

ObjectiveTo determine the effect of dienogest (DNG) on the expression of aromatase and cyclooxygenase-2 (COX-2) and the production of prostaglandin E2 (PGE2) in human endometriotic stromal cells (ESCs).DesignExperimental study in vitro.SettingUniversity hospital.Patient(s)Seventeen patients with ovarian endometrioma.Intervention(s)ESCs from chocolate cyst linings of ovaries were treated with DNG.Main Outcome Measure(s)Expression of aromatase and COX-2 evaluated in spheroid cultures of human ESCs by real-time quantitative polymerase chain-reaction and immunocytochemistry, production of PGE2 quantified by enzyme-linked immunosorbent assay (ELISA), and nuclear factor kappa B (NF-κB) DNA-binding examined by ELISA and immunocytochemistry.Result(s)The pharmaceutical actions of DNG on the expression of aromatase and COX-2 and the production of PGE2 were examined using spheroid cultures of human ESCs. More aromatase, COX-2, and PGE2 were expressed in spheroid cultures than in conventional ESCs monolayers. In the spheroid cultures, DNG (10−7 M) and progesterone (10−7 M) inhibited the expression of aromatase, COX-2, and PGE2. DNG also inhibited NF-κB DNA-binding activity and reduced the immunocytochemical protein expression of aromatase, COX-2, and NF-κB p50 nuclear localization.Conclusion(s)Because DNG inhibits aromatase and COX-2 expression as well as PGE2 production in ESCs, these pharmacologic features might contribute to a therapeutic effect of DNG on endometriosis.