International Journal of Medical Sciences

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25 May 2019

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Int J Med Sci 2018; 15(13):1530-1536. doi:10.7150/ijms.28470

Research Paper

Effect of mistletoe on endometrial stromal cell survival and vascular endothelial growth factor expression in patients with endometriosis

Jeong Min Moon1*, Youn-Jee Chung2*, Boah Chae2, Hee Jin Kang2, Hyun Hee Cho2, Jang Heub Kim2, Mee-Ran Kim2 ✉

1. Bom Women's cinic
2. Department of Obstetrics and Gynecology, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea
* Jeong Min Moon and Youn-Jee Chung contributed equally to this work.

Abstract

Research Question: To evaluate the effect of mistletoe on the cell viability of patients with endometriosis, the expression levels of vascular endothelial growth factor (VEGF) were measured, and the change in the expression level of VEGF following mistletoe treatment was recorded.

Design: Forty reproductive-aged women with endometriosis (stage I/II [group 1, n=20], and stage III/IV [group 2, n=20]) were prospectively enrolled. Twenty women who underwent gynaecologic operations for benign conditions were selected as the control group. Both eutopic and ectopic endometrial tissues were obtained from the endometriosis patients. The endometrial tissues were cultured and the stromal cells were separated. The cells were cultured for 24 hours with peritoneal fluid from patients and controls with and without mistletoe supplementation (200 ng/mL), respectively. The MTT assay was used to assess cell viability, and VEGF expression was analysed by Western blotting and ELISA.

Results: Using peritoneal fluid from endometriosis patients treated with mistletoe, we found that both eutopic and ectopic endometrial stromal cell viability increased after treatment with peritoneal fluid from patients with early-stage (I and II) endometriosis. After mistletoe treatment, the cell viability was decreased, in both eutopic and ectopic endometrial stromal cells in all stages of endometriosis. These findings were verified consistently by evaluating the expression and concentration of VEGF, a marker of angiogenesis.

Conclusions: The present study showed that mistletoe can reduce the cell viability of endometrial stromal cells and the peritoneal fluid-induced elevation of VEGF in eutopic and ectopic endometrial stromal cells obtained from endometriosis patients, especially in the early stage. Mistletoe might have anti-angiogenic activity on endometrial stromal cells and thus is a potential candidate for the treatment of endometriosis.

Keywords: endometriosis, endometrial stromal cell, mistletoe, vascular endothelial growth factor

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How to cite this article:
Moon JM, Chung YJ, Chae B, Kang HJ, Cho HH, Kim JH, Kim MR. Effect of mistletoe on endometrial stromal cell survival and vascular endothelial growth factor expression in patients with endometriosis. Int J Med Sci 2018; 15(13):1530-1536. doi:10.7150/ijms.28470. Available from http://www.medsci.org/v15p1530.htm