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The orphan nuclear receptor 4A1 (NR4A1, Nur77) is expressed in patient-derived (stromal) endometriotic cells and also epithelial cell lines, and we observed that knockdown of NR4A1 in patient-derived ectopic endometrium-isolated ovarian endometrioma (ESECT)-7 and ESECT-40 cells decreased cell proliferation and induced apoptosis. Moreover, the treatment of these cells with bis-indole derived NR4A1 ligands 1,1-bis(3\u2019-indolyl)-1-(p-hydroxyphenyl)methane (DIM-C-pPhOH) and its buttressed 3-chloro-5-methoxy analog (DIM-C-pPhOH-3-Cl-5-OCH3) inhibited cell growth and induced apoptosis and related genes. The compounds exhibit NR4A1 antagonist activities in both functional and transactivation assays whereas these effects were not observed in normal endometrial cells. We also observed that NR4A1 knockdown and treatment with NR4A1 antagonists decreased fibrosis, \u03b1-smooth muscle actin, and related pro-fibrotic genes in ESECT-7 and ESECT-40 cells, and similar results were observed in epithelial-derived endometriotic cell lines. Moreover, in an endometriosis mouse model with auto-transplantation and also in severe combined immune deficiency mice transplanted with human endometriotic cells treatment with 25 mg\/kg\/day DIM-C-pPhOH-3-Cl-5-OCH3 significantly inhibited growth and expansion of endometriotic lesions. Thus, bis-indole\u2013derived NR4A1 ligands represent a novel class of drugs as nonhormonal therapy for endometriosis.<\/jats:p>","DOI":"10.1210\/endocr\/bqaa027","type":"journal-article","created":{"date-parts":[[2020,2,26]],"date-time":"2020-02-26T01:22:07Z","timestamp":1582680127000},"source":"Crossref","is-referenced-by-count":32,"title":["Bis-Indole\u2013Derived Nuclear Receptor 4A1 (NR4A1, Nur77) Ligands as Inhibitors of Endometriosis"],"prefix":"10.1210","volume":"161","author":[{"given":"Kumaravel","family":"Mohankumar","sequence":"first","affiliation":[{"name":"Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, TX US"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xi","family":"Li","sequence":"first","affiliation":[{"name":"Department of Veterinary Physiology and Pharmacology, Texas A&M University, College Station, TX 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