{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,13]],"date-time":"2026-04-13T12:34:11Z","timestamp":1776083651052,"version":"3.50.1"},"reference-count":34,"publisher":"MDPI AG","issue":"11","license":[{"start":{"date-parts":[[2024,10,24]],"date-time":"2024-10-24T00:00:00Z","timestamp":1729728000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"German Research Foundation (DFG)"},{"name":"OpenAccess Publication Fund of Charit\u00e9\u2014Universit\u00e4tsmedizin Berlin"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Biomolecules"],"abstract":"<jats:p>Adenomyosis (AM) is a gynecological disease characterized by the invasion of endometrial glands and stroma within the myometrium. The etiology and pathogenesis of AM remain inadequately understood. Pale cells were identified as a novel cell type characterized by the absence of desmosomal contacts and light-colored cytoplasm. These cells were observed to migrate individually through ultra-micro ruptures in the basal membrane of the endometrial glands, translocating into the stroma and then further into the myometrium. Our study aimed to explore the possible stem cell properties of these pale cells. Forty hysterectomy specimens were analyzed using immunohistochemistry and immunofluorescence to assess negative E-cadherin expression and the positive expression of stem cell markers SSEA-1, MSI-1, and SOX-2. Immunohistochemical analysis revealed the presence of pale cells and occasionally rounded, enlarged E-cadherin-negative cells predominantly in the basal endometrial epithelium. The stem cell marker SSEA-1 was significantly elevated in the basalis epithelium, as well as in the ectopic epithelium. SSEA-1 positive cells were also identified in the stroma and myometrium. Sporadic colocalization of SSEA-1+\/E-cadherin\u2013 cells was confirmed through immunofluorescence. The positive staining of pale cells for SSEA-1 and MSI-1 was also confirmed at the ultrastructural level by immunoelectron microscopy. These findings indicate that pale cells may possess stem cell characteristics, particularly a positive SSEA-1 profile, warranting further in vitro investigation into their role in the pathogenesis of adenomyosis.<\/jats:p>","DOI":"10.3390\/biom14111355","type":"journal-article","created":{"date-parts":[[2024,10,25]],"date-time":"2024-10-25T03:46:04Z","timestamp":1729827964000},"page":"1355","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Characterization of E-Cadherin, SSEA-1, MSI-1, and SOX-2 Expression and Their Association with Pale Cells in Adenomyosis"],"prefix":"10.3390","volume":"14","author":[{"given":"Jingjun","family":"Tian","sequence":"first","affiliation":[{"name":"Department of Gynecology Charit\u00e9 with Center of Oncological Surgery, Endometriosis Research Center Charit\u00e9, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronika","family":"Hoffmann","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, Labor PAN-Zentrum, Vesaliusweg 2\u20134, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohamed Gamal","family":"Ibrahim","sequence":"additional","affiliation":[{"name":"Department of Gynecology Charit\u00e9 with Center of Oncological Surgery, Endometriosis Research Center Charit\u00e9, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany"},{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, Labor PAN-Zentrum, Vesaliusweg 2\u20134, 48149 M\u00fcnster, Germany"},{"name":"Team Kinderwunsch Oldenburg, 26121 Oldenburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Uwe","family":"Hansen","sequence":"additional","affiliation":[{"name":"Institute of Musculoskeletal Medicine, University Hospital M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andreas N.","family":"Sch\u00fcring","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, Labor PAN-Zentrum, Vesaliusweg 2\u20134, 48149 M\u00fcnster, Germany"},{"name":"Fertility Centre KITZ Regensburg, 93047 Regensburg, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0788-1640","authenticated-orcid":false,"given":"Renata Voltolini","family":"Velho","sequence":"additional","affiliation":[{"name":"Department of Gynecology Charit\u00e9 with Center of Oncological Surgery, Endometriosis Research Center Charit\u00e9, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sylvia","family":"Mechsner","sequence":"additional","affiliation":[{"name":"Department of Gynecology Charit\u00e9 with Center of Oncological Surgery, Endometriosis Research Center Charit\u00e9, Campus Virchow-Klinikum, Augustenburger Platz 1, 13353 Berlin, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2360-2496","authenticated-orcid":false,"given":"Martin","family":"G\u00f6tte","sequence":"additional","affiliation":[{"name":"Department of Gynecology and Obstetrics, M\u00fcnster University Hospital, Labor PAN-Zentrum, Vesaliusweg 2\u20134, 48149 M\u00fcnster, Germany"},{"name":"Cells in Motion Interfaculty Centre, University of M\u00fcnster, 48149 M\u00fcnster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2024,10,24]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"213","DOI":"10.1159\/000068385","article-title":"Correlations between extent and spread of adenomyosis and clinical symptoms","volume":"54","author":"Sammour","year":"2002","journal-title":"Gynecol. 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