Patients and sample collection
Normal endometrial samples were collected from healthy fertile women aged 25–35 years who had no evidence of endometrial abnormalities, endometriosis or adenomyosis. All samples were collected with the informed consent of the patients, and approval from the ethics committee was obtained for this study. During the mid-secretory phase of menstruation, 8–9 days after ovulation, endometrial tissue samples were collected. Eutopic endometrial tissue samples were collected from age-matched patients with laparoscopically diagnosed with EMs. Endometrial biopsy was performed under an approved Human Investigations Committee protocol. All patients enrolled in the study exhibited regular menstruation and had no history of hormone treatment before surgery. All patients signed an informed consent form before the operation, and this study was approved by the Drum Tower Hospital Research and Ethics Committee.
Isolation of human endometrial stromal cells (HESCs) and artificial induction of decidualization in vitro
HESCs were isolated from normal endometrial tissue obtained by endometrial biopsy from normally cycling women who had not received hormone treatment for at least three months. HESCs were isolated as previously described[13]. HESC decidualization in vitro was induced as previously described[14]. For particular treatments, cells were pre-treated with Ad-GFP-CAPN7,Ad-Myc-FOXO1, siCAPN7, or si-Ctrl for 2 days and then treated with 8-Br-cAMP and MPA for 3 days.
Immunohistochemistry
Human uterine endometrial sections were treated as previously described[14] except that the sections were incubated with antibodies against CAPN7 (1:50 dilution, Novus Biologicals, CO, USA, NBP2-14436),phospho-FOXO1 (S319) (1:1000 dilution, Abcam, USA༌ab47326)༌AKT1 (1:1000 dilution, CST, USA, 2938S), phospho-Akt (S473) (1:1000 dilution, CST, USA, 4060S) overnight at 4 ℃. Control sections were processed concurrently using PBS or rabbit IgG and similarly pretreated. The representative objective protein relative expression level was determined according to the mean and integrated optical density (IOD) of the digital image (×400) according to the software's instructions. In this study, we only calcite the staining score of the endometrium stromal cells.
Western blotting
HESCs were lysed using whole-cell lysis buffer, and HESC proteins were treated as specified by the instructions of the nuclear and cytoplasmic protein extraction kit (Thermo). Protein concentrations were quantified using the Bradford assay (Bio-Rad Laboratories, Hercules, USA). The proteins (30 µg) were separated using 10% SDS-PAGE and transferred to polyvinylidene fluoride (PVDF) membranes (Millipore, Billerica, USA). The membranes were then blocked for 1 h in 5% nonfat milk. Subsequently, the membranes were exposed to primary antibodies against CAPN7 (1:3000 dilution, Novus Biologicals, CO, USA, NBP2-14436), Flag-HRP (1:5000 dilution, Sigma, St. Louis, USA, 7425), GFP (1:1,000; beyotime, Shanghai, China, AG281), FOXO1A (1:2000 dilution, Abcam, USA, ab39670), phospho-FOXO1 (S319) (1:1000 dilution, Abcam, USA, ab47326), FOXO1 (T24) (1:1000 dilution, Abcam, USA, ab58517), phospho-FOXO1 (S256) (1:1000 dilution, Abcam, USA, ab131339), AKT1 (1:1000 dilution, CST, USA, 2938S), phospho-Akt (S473) (1:1000 dilution, CST, USA, 4060S), and HSP90B (1:5000 dilution, Bioworld Technology, St. Louis, USA, BS1181); GAPDH (1:10,000; Bioworld Technology St. Louis, USA, AP0063) or β-actin (1:5000 dilution, Bioworld Technology, St. Louis, USA, AP0060) was also quantified as an internal control. An anti-rabbit secondary antibody, an anti-mouse secondary antibody and an enhanced chemiluminescence kit (Millipore, Billerica, USA) were used for final immunodetection.
RNA isolation and real-time quantitative PCR
Total RNA was isolated from cells using TRIzol (Life Technologies, New York, USA) according to the manufacturer’s instructions. RNA (1 µg) was reverse transcribed to obtain cDNA and diluted 1:4 before use. The total reaction volume of 20 µL contained 2 µL of RNA and contained 2 µL of RNA and ChamQ Universal SYBR qPCR Master Mix (Vazyme, Nanjing, China, Q711-02). Real-time PCR analysis was performed with SYBR Green dye and measured on an Analytik Jena instrument to quantify the mRNA levels. The housekeeping gene 18S rRNA was used as an internal control. The specific primers sequences are listed in Table S1.
siRNA knockdown assay
A pair of small interfering RNA oligonucleotides specific for human CAPN7 (sense strand: 5’-CAUUAGUGGUUUCUCAAUAdTdT-3’ and 3’-dTdT GUAAUCACCAAAGAGUUAU-5’) and a pair of control siRNA oligonucleotides were synthesized by RIBOBIO (Guangzhou, China). At 60-70% confluence, HESCs were transfected with siRNAs by using SuperFectTMII (Pufei Biotech, Shanghai, China) transfection reagent at a final concentration of 50 nM according to the manufacturer’s recommendations.
Prolactin and IGFBP-1 assays
The HESC supernatant was collected in 6-well plates on the third, sixth, and ninth days after treatment with 8-Br-cAMP and MPA. PRL and IGFBP-1 levels in supernatant were measured using Elecsys Prolactin II (Roche, Switzerland) and Human IGFBP1 ELISA kits (BOSTER, Wuhan, China). The limit of detection of the Vidas Prolactin kit was 0.5 ng/ml, and the detection range of the human IGFBP1 ELISA kit was 31.2-2000 pg/ml. DMEM/F12 supplemented with charcoal/dextran-treated FBS did not contain measurable prolactin or IGFBP-1.
Transient transfection and luciferase reporter assays
The wild-type IGFBP-1 promoter sequence (-1050 to -113) was amplified by PCR from human endometrial stromal cell genomic DNA with the primers 5’- TATATTATTATCTCGAGACAGGAGGCCCAGGCCTGGAG-3’ and 5’- CTGACTGATTAAAGCTTGTTTTGCTAGTGCACCCAAGG-3’. The PCR product was cloned into the pGL3-basic luciferase reporter plasmid (Promega, Madison, WI, USA). The dPRL reporter plasmid was described elsewhere[15]. At 60% confluence, HESCs in 12-well plates were infected with Ad-CTL or Ad-Flag-CAPN7 and/or Ad-Flag-FoxO1 for 24 h, and the cells were then transfected with the dPRL reporter plasmid (450 ng/well), IGFBP-1 reporter plasmid (200 ng/well) or IRS (insulin-responsive sequence) luciferase reporter plasmid (200 ng/well) (Addgene, MA, USA), together with the Renilla luciferase reporter plasmid pRL-RSV (10 ng) (Promega, Madison, USA), using the Lip2000 transfection reagent (Life Technologies, New York, USA). Six hours after transfection, HESCs were stimulated with 8-Br-cAMP and MPA. After three days, the cell lysates were assayed for luciferase activity. Firefly luciferase activity was normalized for the transfection efficiency according to corresponding Renilla luciferase activity.
Construction of plasmid and adenovirus
The pCMV-Flag-CAPN7, pEGFP-C1-CAPN7, pCMV-Flag-AKT1 and pEGFP-N1-AKT1 plasmids were obtained by cloning the CAPN7 or AKT1 cDNA obtained by PCR amplification from total human cDNA, which was subcloned into the BglII- BamHII sites of a pFlAG-CMV, pEGFP-C1/N1 backbone plasmid. The FoxO1 cDNA PCR fragment was digested with the XhoI and XbaI restriction enzymes and cloned in a pCS2-myc plasmid digested in a similar manner. The specific primers are listed in table S2. All of the vectors were examined and verified by restriction analysis and sequencing. The adenoviruses were packaged and amplified as previously described[16].
Coimmunoprecipitation
For the coimmunoprecipitation (co-IP) of CAPN7 and FoxO1 or CAPN7 and AKT1, HEK293T cells were co-transfected with the indicated expression plasmids, and cell lysates were prepared 2 days post transfection. Equal amounts of total proteins (600 µg) were precleared by incubation with protein A/G plus-agarose beads (Abmart, Shanghai, China, A10001) and gently shaken at 4 ℃ for 2 h. The supernatant was incubated with Flag antibody-conjugated beads (Sigma, St. Louis, USA, M8823) at 4 ℃ overnight with gentle shaking, followed by four washes in 1 ml of lysis buffer. The immunocomplex was separated by SDS-PAGE, and the proteins were detected with the indicated antibodies. The Co-IP of GFP-CAPN7 and endogenous AKT1 and FoxO1 was performed using the total proteins (1 mg) from decidualized HESCs infected with Ad-GFP-CAPN7. The proteins were then treated as described above
Immunofluorescence staining
HESCs plated on 18 mm micro-cover glasses (Matsunami, Osaka, Japan) were infected with Ad-GFP-CAPN7 and then treated with or without 8-Br-cAMP plus MPA for 60 h. Subsequently, HESCs were treated as previously described[9] except that the cells were incubated with an anti-FoxO1 antibody (Cell Signalling Technology, Beverly, Massachusetts, USA, 2880S) to label endogenous FoxO1 protein at 4 ℃ overnight, and Alexa Fluor 594-conjugated goat anti-rabbit IgG (Life Technologies, New York, USA, A-11012) was applied on the second day. The results were visualized using an FV10i-LIV/FV10i-DOC confocal laser scanning biological microscope (Olympus Corporation, Shinjuku, Tokyo, Japan).
Artificial induction of decidualization
All of the experimental procedures were performed according to the guidelines of the Experimental Animal Management Committee (Jiangsu Province, China) and were approved by the Ethics Review Board for Animal Studies of Drum Tower Hospital, Nanjing University Medical School. Four- to six-week-old female ICR mice were purchased from the Nanjing Biomedical Research Institute of Nanjing University. The mice were housed in a room maintained under IVC constant environmental conditions, with a temperature of 22–24°C and a 12-hr light/dark cycle. Mice at 6–8 wk of age were ovariectomized under isoflurane anaesthesia and 20 µl (2 × 108 TU/side) of Ad-GFP or Ad-GFP-CAPN7 were injected into the uterine lumen. After 1 wk, Ad-GFP-CAPN7 was injected into the tail veins of the mice, and Ad-lacZ was injected as a control. After an additional 1 wk to allow endogenous ovarian hormones to disappear completely, the mice were subjected s.c. injections of E2 (100 ng) daily for 3 d. After 2 d of rest, the mice were treated with 1 mg of P4 s.c. and 10 ng of E2 s.c. daily for 3 d. A second surgery was performed 6 h after the last hormone injection to expose one uterine horn. Decidualization was induced in this horn by the injection of 20 µL of sesame oil into (sigma)the lumen. The other uterine horn was left untreated as a control. Daily treatments (1 mg of P4 s.c. and 10 ng of E2 s.c.) were continued for 4 d. The mice were killed 6 h after the last oil injection, and the wet weights of the traumatized and control uterine horns of each mouse were recorded. Uterine tissue was collected from both horns and fixed in 10% neutral buffered formalin[17].
Statistical analysis
Unless stated otherwise, the presented numerical data are the mean ± SD from at least three experiments. Statistical analyses were performed using Prism version 6 software. Statistical differences in the mean expression values of the two treatment groups were compared using a two-tailed Student’s t-test. One-way ANOVA was performed for comparisons among more than two groups.