2019 Volume 89 Issue Extra1 Pages E110-E117
During various events in the reproductive period (viz., menstruation and delivery) of a woman, the endometrium displays phenomenal regenerative ability to repeat the cycle of shedding and regeneration. However, the mechanisms responsible for complete inner membrane repair and regeneration remain mostly unexplored. Gynecological diseases, such as placenta accreta and implantation failure, are caused by insufficient repair of the endometrium. However, because the mechanism behind these diseases are unclear, there are no known preventive methods. Changes in oxygen concentration in the endometrium are known to be involved in defense against bacteria and trophoblast invasion for the establishment of pregnancy. Additionally, it is also thought to affect angiogenesis and tissue repair. The difficulty of obtaining human samples, hampers investigation along this line of research. Using a postpartum mouse model and mice with sub-involuted uterus, we have reported that changes in intrauterine oxygen concentration, including hypoxia, due to involution of the uterine smooth muscle are responsible for scarless endometrial repair. Elucidation of the regenerating mechanism of the endometrium provides possibilities to prevent complications in obstetrics and gynecology, and a strong basis for scarless tissue repair through a new approach of generating microenvironments based on oxygen concentration adjustment in normal tissues. In this review, we discuss the role of microenvironment in the process of healing and regeneration of the endometrium.
