Progestin-induced heart and neural crest derivatives expressed transcript 2 is associated with fibulin-1 expression in human endometrial stromal cells

Objective: To investigate whether heart and neural crest derivatives expressed transcript 2 (HAND2) regulates fibulin-1 (FBLN1) expression during decidualization of human endometrial stromal cells (ESCs). Design: In vitro experiment. Setting: Research laboratory. Patient(s): Twenty-four patients undergoing hysterectomy for benign reasons. Intervention(s): ESCs were cultured with various progestins (medroxyprogesterone acetate [MPA], norethisterone, levonorgestrel, dienogest, and P), E-2, dexamethasone, and/or 8-bromoadenosine 3', 5'-cyclic monophosphate (8-Br-cAMP). HAND2 and FBLN1 were silenced by small interfering RNA technology. Main Outcome Measure(s): HAND2 and FBLN1 expression levels were assessed by real-time polymerase chain reaction and Western blot analysis. Result(s): MPA or E-2 + MPA increased HAND2 mRNA levels in ESCs in a time-and dose-dependent manner, and this stimulatory effect was blocked by RU-486 (P receptor antagonist). HAND2 was increased by E-2 + MPA earlier than FBLN1. Simultaneous MPA and 8-Br-cAMP treatment synergistically enhanced HAND2 mRNA levels. P and all the progestins significantly increased HAND2 mRNA levels, whereas E-2, 8-Br-cAMP, or dexamethasone alone had no effect. Silencing of HAND2 expression significantly reduced FBLN1 expression, whereas FBLN1 silencing had no effect on HAND2 expression. Conclusion(s): These results suggest that progestin-induced HAND2 contributes to FBLN1 expression in human ESCs. (Fertil Steril (R) 2013;99:248-55. (C) 2013 by American Society for Reproductive Medicine.)