Although estrogen has crucial functions for endometrium growth, the specific dose
and underlying molecular mechanism in intrauterine adhesion (IUA) remain
unclear. In this study, we aimed to investigate the effects of estrogen on
epithelial-mesenchymal transition (EMT) in normal and fibrotic endometrium, and
the role of estrogen and Wnt/β-catenin signaling in the formation of endometrial
fibrosis. CCK-8 and immunofluorescence assay were performed to access the
proliferation of different concentrations of estrogen on normal human
endometrial epithelial cells (hEECs). qRT-PCR and western blot assay were
utilized to explore the effect of estrogen on EMT in normal and fibrotic
endometrium, and main components of Wnt/β-catenin signaling pathway
in
vitro
. Hematoxylin and eosin and Masson staining were used to
evaluate the effect of estrogen on endometrial morphology and fibrosis
in vivo
. Our results indicated that the proliferation of
normal hEECs was inhibited by estrogen at a concentration of 30 nM accompanied
by upregulation of mesenchymal markers and downregulation of epithelial markers.
Interestingly, in the model of transforming growth factor β1 (TGF-β1)-induced
endometrial fibrosis, the same concentration of estrogen inhibited the process
of EMT, which might be partially mediated by regulation of the Wnt/β-catenin
pathway. In addition, relatively high doses of estrogen efficiently increased
the number of endometrial glands and reduced the area of fibrosis as determined
by the reduction of EMT in IUA animal models. Taken together, our results
demonstrated that an appropriate concentration of estrogen may prevent the
occurrence and development of IUA by inhibiting the TGF-β1-induced EMT and
activating the Wnt/β-catenin pathway.