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Volume 14
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10.3390/cells14231891
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Article

Endometrial Stromal Cells from Endometriosis Patients Reflect Lesion-Type-Specific Heterogeneity

by
Daniel Rodriguez Gutierrez
1,†,
Marianne R. Spalinger
1,*,†,
Alina Astourian
1,
Olivera Evrova
1,
Lucie Berclaz
1,
Monique Hartmann
1,
Ioannis Dedes
2,
Patrick Imesch
2,
Julian M. Metzler
2,
Isabelle Witzel
2,
Mohaned Shilaih
1,
Valentina Vongrad
1 and
Brigitte Leeners
1
1
Department of Reproductive Endocrinology, University Hospital Zurich, 8091 Zurich, Switzerland
2
Department of Gynecology, University Hospital Zurich, 8091 Zurich, Switzerland
*
Author to whom correspondence should be addressed.
†
These authors contributed equally to the manuscript.
Cells 2025, 14(23), 1891; https://doi.org/10.3390/cells14231891
Submission received: 10 October 2025 / Revised: 16 November 2025 / Accepted: 24 November 2025 / Published: 28 November 2025
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Abstract

Endometriosis, a disease affecting about one out of ten women, is characterized by the growth of endometrial-like tissue outside the uterine cavity. There is significant disease heterogeneity, but the pathophysiological mechanisms underlying differences in clinical presentation are poorly understood. Here, we investigated endometrial stromal cells (ESCs) from different types of endometrial lesions (endometrioma, superficial, and deep endometrial lesions), which revealed distinct differences in proliferation, migration, and contractility among different lesion types and when compared to ESC from normal (eutopic) endometrium. In particular, ESCs from endometriotic lesions showed reduced proliferation but increased migratory capacity, an effect most pronounced in endometrioma ESCs but also evident in ESCs from superficial and deep lesions. ESCs from superficial and deep lesions—but not those from endometrioma—showed increased contractility, a feature involved in tissue scarring and pain perception. Transcriptomics and proteomics revealed changes in genes and proteins involved in cell division, proliferation, extracellular matrix organization, and migration in endometriosis vs. healthy ESCs. Overall, our results demonstrate that stromal cells from different endometriotic lesions show distinct in vitro phenotypes that might explain differences in clinical presentation. Further, these cells represent an excellent in vitro model for studying patho-mechanisms involved in endometriosis heterogeneity.
Keywords: endometriosis; endometrium; endometriotic lesion types; endometrioma; deep infiltrating endometriosis; stromal cells; cell isolation; primary cell model endometriosis; endometrium; endometriotic lesion types; endometrioma; deep infiltrating endometriosis; stromal cells; cell isolation; primary cell model

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MDPI and ACS Style

Rodriguez Gutierrez, D.; Spalinger, M.R.; Astourian, A.; Evrova, O.; Berclaz, L.; Hartmann, M.; Dedes, I.; Imesch, P.; Metzler, J.M.; Witzel, I.; et al. Endometrial Stromal Cells from Endometriosis Patients Reflect Lesion-Type-Specific Heterogeneity. Cells 2025, 14, 1891. https://doi.org/10.3390/cells14231891

AMA Style

Rodriguez Gutierrez D, Spalinger MR, Astourian A, Evrova O, Berclaz L, Hartmann M, Dedes I, Imesch P, Metzler JM, Witzel I, et al. Endometrial Stromal Cells from Endometriosis Patients Reflect Lesion-Type-Specific Heterogeneity. Cells. 2025; 14(23):1891. https://doi.org/10.3390/cells14231891

Chicago/Turabian Style

Rodriguez Gutierrez, Daniel, Marianne R. Spalinger, Alina Astourian, Olivera Evrova, Lucie Berclaz, Monique Hartmann, Ioannis Dedes, Patrick Imesch, Julian M. Metzler, Isabelle Witzel, and et al. 2025. "Endometrial Stromal Cells from Endometriosis Patients Reflect Lesion-Type-Specific Heterogeneity" Cells 14, no. 23: 1891. https://doi.org/10.3390/cells14231891

APA Style

Rodriguez Gutierrez, D., Spalinger, M. R., Astourian, A., Evrova, O., Berclaz, L., Hartmann, M., Dedes, I., Imesch, P., Metzler, J. M., Witzel, I., Shilaih, M., Vongrad, V., & Leeners, B. (2025). Endometrial Stromal Cells from Endometriosis Patients Reflect Lesion-Type-Specific Heterogeneity. Cells, 14(23), 1891. https://doi.org/10.3390/cells14231891

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