Études des rôles physiopathologiques de PTEN dans le tractus reproducteur femelle

The granulosa cell tumor (GCT) represents up to 5% of all ovarian cancer cases in women. Although GCT is characterized as a low-grade malignancy, death occurs in approximately 80% of cases following to the disease’s recurrence. Despite these statistics, very few studies have been dedicated to increasing our understanding of the molecular mechanisms responsible for the development of GCT. The first objective of this work was to elucidate some of these molecular mechanisms by proving the involvement of the PI3K/AKT signaling pathway in the etiology of GCT. To this end, we used Cre-LoxP technology to conditionally target Pten (a PI3K/AKT signaling antagonist) in granulosa cells. These transgenic mice (Ptenflox/flox;Amhr2cre/+) occasionally developed GCT, supporting our hypothesis on the importance of the PI3K/AKT pathway in the etiology of this disease. The WNT/CTNNB1 signaling pathway has also recently been implicated in GCT development. We therefore postulated that a functional synergy may exist between the WNT/CTNNB1 and PI3K/AKT pathways in development of GCT. To test this, we created a second transgenic model (Ptenflox/flox;Ctnnb1flox(ex3)/+;Amhr2cre/+), in which the granulosa cells featured not only a disinhibition of the PI3K/AKT pathway but also a constitutive activation of the WNT/CTNNB1 pathway. As predicted, the Ptenflox/flox;Ctnnb1flox(ex3)/+;Amhr2cre/+ mice developed a form of GCT that was much more aggressive than the one observed in the Ptenflox/flox;Amhr2cre/+ model. Specifically, the tumors developed sooner, their growth was faster, pulmonary metastases and the seeding of tumor cells in the abdominal cavity were observed, and the disease was invariably fatal by 8 weeks of age. The Ptenflox/flox;Ctnnb1flox(ex3)/+;Amhr2cre/+ model therefore served to demonstrate a synergy between the WNT/CTNNB1 and PI3K/AKT pathways in GCT development. Unexpectedly, the majority of the Ptenflox/flox;Amhr2cre/+ females presented an infertility phenotype that was not caused by an ovarian defect. Recently, it has been shown that the Amhr2cre strain can direct the Cre activity not only to the granulosa cells but also to the uterine stroma and myometrium. The second objective of this work was therefore to determine if and how the infertility observed in Ptenflox/flox;Amhr2cre/+ mice could be caused by a uterine defect. During implantation, uterine stromal cells differentiate into decidual cells and form the maternal decidua (MD), which subsequently regresses by apoptosis to facilitate trophoblast invasion. In collaboration with the fetal tissue, the MD also recruits uNKs, which are responsible for spiral artery remodeling that increases maternal blood flow to the developing fetus. We were able to demonstrate that the uteri of pregnant Ptenflox/flox;Amhr2cre/+ females had a MD that was resistant to apoptosis, less uNKs, and spiral arteries that were not properly remodeled. Consequently, the trophoblast cell invasion was restricted, thereby compromising the development and survival of the embryo. We have therefore established for the first time the importance of Pten during the decidualization of the uterine stroma and trophoblast invasion.

Keyphrases: Pten, Akt, Transgenic mice, Animal modeling, Granulosa cell tumor, Trophoblast, Decidua, Myometrium