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ZEB1 Drives Epithelial-Mesenchymal Transition and Hormone Resistance in Endometriosis

Endometriosis, a chronic inflammatory condition affecting an estimated one in ten women of reproductive age, has long frustrated clinicians with its stubborn tendency to recur despite surgery and hormone therapy. A new review published in Reproductive Sciences argues that the answer to this therapeutic failure may lie in a single transcription factor: ZEB1, or Zinc Finger E-Box Binding Homeobox 1. Written by Gaurav Doshi and Sanket Shirodkar of SVKM’s Dr. Bhanuben Nanavati College of Pharmacy in Mumbai, the review synthesises evidence from across the field to position ZEB1 as a master molecular integrator—converging hormonal, inflammatory and epigenetic signals into a single programme that drives lesion establishment, invasiveness and drug resistance.

The biological centrepiece of the review is epithelial–mesenchymal transition, or EMT, the process by which epithelial cells lose their adhesive, stationary character and acquire the migratory, invasive traits of mesenchymal cells. In endometriosis, EMT is thought to be essential for the survival of endometrial cells that reflux into the pelvic cavity during menstruation and subsequently implant on peritoneal surfaces, ovaries and other ectopic sites. ZEB1 sits at the apex of this programme. It suppresses CDH1, the gene encoding E-cadherin, the principal adhesion molecule holding epithelial sheets together, and in doing so dismantles the cell–cell junctions that would otherwise keep ectopic cells anchored and vulnerable. The review details how ZEB1 accomplishes this repression by recruiting chromatin-remodelling machinery, notably the SWI/SNF ATPase subunit BRG1, to the E-cadherin promoter, effectively silencing it epigenetically. The result is a stabilised mesenchymal differentiation that permits attachment, invasion and, ultimately, the vascularisation required for a lesion to persist.

Crucially, the authors argue that ZEB1 is not merely one EMT factor among many, such as SNAI1, SNAI2 or its paralog ZEB2, but a systems-level hub. Immunohistochemical and molecular studies have repeatedly shown selective upregulation of ZEB1 in ectopic endometriotic lesions compared with matched eutopic endometrium, and its expression is particularly pronounced in deep infiltrating disease. One frequently cited clinical study found ZEB1 expression to be a potential indicator of invasive endometriosis, while a pilot investigation of different disease phenotypes has extended these observations across superficial, ovarian and deep infiltrating subtypes. Measurable ZEB levels have even been detected in plasma and peritoneal fluid of patients with endometriosis and infertility, raising the prospect of ZEB-family proteins as circulating biomarkers.

Perhaps the most consequential section of the review concerns the bidirectional crosstalk between ZEB1 and sex steroid signalling. Endometriosis is a hormone-dependent disease, and its defining therapeutic problem is progesterone resistance: lesions fail to respond to the progestational drugs used to suppress them. The review marshals evidence that oestrogen, specifically 17β-estradiol, induces ZEB1 expression, and that ZEB1 in turn suppresses progesterone receptor pathways. This creates a self-reinforcing circuit in which the oestrogen-ZEB1 axis dismantles the molecular machinery that progesterone therapy depends upon. Experimental work has demonstrated that high ZEB1 expression accompanies 17β-estradiol-induced EMT in endometriotic cells, and parallel findings from other hormone-driven diseases reinforce the mechanism: in breast cancer, ZEB1 induces oestrogen receptor-α promoter hypermethylation and confers antiestrogen resistance, and ZEB-family members have been shown to regulate endocrine therapy sensitivity through both canonical and non-canonical routes. In endometriosis, EMT itself has been shown to contribute to the downregulation of progesterone receptor expression in lesions, and the near-uniform loss of progesterone receptor isoform B in ectopic tissue is a long-standing observation that the ZEB1 framework now helps to explain mechanistically.

The review also devotes substantial attention to the non-coding RNA dimension of ZEB1 regulation, describing a multilayered feedback architecture that locks the mesenchymal state in place. The miR-200 family of microRNAs normally targets the 3′ untranslated regions of ZEB1 and ZEB2 transcripts, holding EMT in check. In ectopic lesions, this double-negative feedback loop is subverted: ZEB1 represses miR-200 transcription, and the resulting loss of miR-200 pressure allows ZEB1 protein to accumulate. Long non-coding RNAs add another tier. The lncRNA AFAP1-AS1, for example, promotes EMT in endometriosis in a ZEB1-correlated manner, and the metastasis-associated transcript MALAT1 has been implicated in the same circuitry, with miR-200c suppressing endometriotic progression in vitro and in vivo by targeting it. Circular RNAs complete the picture. The circRNA circZFPM2 has been shown to promote EMT by sponging miR-205-5p and thereby releasing ZEB1 from repression, while hsa_circ_0063526 acts through the miR-141-5p/EMT axis and circATRNL1 acts upstream by upregulating the EMT cofactor YAP1. Together these competing endogenous RNA networks—a concept also validated in metastatic cancer by J Clin Invest work—build a ceRNA web that perpetuates ZEB1 expression long after the initial pro-EMT stimulus has passed.

The authors then connect ZEB1 to the two great downstream consequences of endometriotic lesions: chronic inflammation and fibrosis. Through interactions with the TGF-β pathway—upstream signals such as TGF-β1 activate SMAD2/3, which cooperate with ZEB1 to drive the mesenchymal programme—ZEB1-linked cells reshape the lesion microenvironment. Fibroblast-to-myofibroblast transdifferentiation, marked by α-smooth muscle actin expression, generates the dense extracellular matrix characteristic of endometriotic implants, and analogous MRTF-A–ZEB1–IRF9 axes have been documented in renal fibrosis. Inflammation completes the loop: pro-inflammatory cytokines such as TNF-α, IL-6 and IL-10, and peritoneal fluid cytokine profiles that differ across endometriosis subphenotypes, feed back into EMT signalling through MAPK, ERK, PI3K/AKT and NF-κB pathways, while immune evasion mechanisms—including indoleamine 2,3-dioxygenase-mediated suppression of natural killer cell cytotoxicity—shield ectopic tissue from immune clearance. ZEB1’s own roles in immune cell biology and in macrophage efferocytosis and mitochondrial dynamics add further dimensions to this immunological interplay.

A distinctive strength of the review is its engagement with modern genomics and the heterogeneity it has revealed. Single-cell transcriptomic analyses of endometriosis, published in Nature Genetics and the Journal of Pathology, have identified distinct hormonal, immunologic and inflammatory signatures among the cell populations constituting lesions, and spatial transcriptomics is beginning to map how intermediate fibroblast and myeloid cell distributions shape lesion architecture. ZEB1 expression, the authors note, is not uniform: it varies by lesion subtype, anatomical site and microenvironmental context, which helps explain why superficial peritoneal, ovarian endometrioma and deep infiltrating disease behave so differently and respond so unevenly to therapy. This heterogeneity argues strongly against a one-size-fits-all anti-ZEB1 strategy and supports the emerging precision-medicine framing of the oestrogen-ZEB1-TGF-β axis as the central therapeutic target.

The review is refreshingly candid about the translational paradox at the heart of any ZEB1-directed therapy. Far from being a purely pathological molecule, ZEB1 has indispensable physiological functions in the female reproductive tract. In vitro studies show that ZEB1 modulates endometrial receptivity through EMT in endometrial epithelial cells, and work in mice demonstrates that it promotes EMT of endometrial epithelium and plays a critical role in embryo implantation. ZEB1 is also detected in granulosa cells of women undergoing IVF, regulates wound angiogenesis and closure, participates in corneal homeostasis, and contributes to endometrial repair during menstruation through epithelial migration and mesenchymal–epithelial transition. Blanking ZEB1 systemically, therefore, risks impairing fertility, tissue regeneration and wound healing—the very outcomes clinicians are trying to protect. Any therapeutic strategy would need to be lesion-specific, temporally controlled and carefully titrated, perhaps by targeting upstream oestrogen-driven induction, the TGF-β/ALK5 arm, the non-coding RNA sponges, or post-translational stabilisation mechanisms such as ZEB1 acetylation, phosphorylation and ubiquitin-proteasome turnover via regulators like USP51 and SIAH1/2.

The authors also stress the need for better experimental models to establish causal rather than merely correlative relevance. shRNA- and siRNA-based knockdown of ZEB1 in endometriotic cells, three-dimensional patient-derived endometriosis models for drug evaluation, and multi-omics approaches that integrate transcriptomic, epigenomic and proteomic data—including recent ubiquitination-focused studies of endometriosis fibrosis—are all highlighted as tools that could convert the ZEB1 hypothesis into testable interventions. Biomarker development is another avenue: ZEB-family levels in plasma and peritoneal fluid, in combination with existing miRNA signatures, could one day support non-invasive diagnosis, a long-standing unmet need given that current detection still relies on laparoscopy.

Ultimately, the review’s central claim is that the oestrogen–ZEB1–TGF-β axis functions as a signalling hub through which the hormonal, inflammatory and epigenetic drivers of endometriosis converge and perpetuate one another. By identifying ZEB1 as the point of integration, the authors provide a mechanistic scaffold that could explain progesterone resistance, fibrotic progression and recurrence within a single framework, and they chart a cautious but concrete path toward mechanism-based, lesion-specific precision therapies. For a disease that has historically been managed with blunt hormonal and surgical instruments, the prospect of intervening at the level of a single, druggable transcriptional circuit represents one of the more compelling conceptual advances in endometriosis research in recent years.

Subject of Research: The role of the transcription factor ZEB1 as a central regulator of epithelial–mesenchymal transition and hormonal resistance in endometriosis

Article Title: Deciphering the Role of ZEB1 as a Central Regulator of Epithelial–Mesenchymal Transition and Hormonal Resistance in Endometriosis

Article References: Doshi, G., & Shirodkar, S. (2026). Deciphering the Role of ZEB1 as a Central Regulator of Epithelial–Mesenchymal Transition and Hormonal Resistance in Endometriosis. Reproductive Sciences. https://doi.org/10.1007/s43032-026-02181-w

Image Credits: AI Generated

DOI: 10.1007/s43032-026-02181-w

Keywords: Endometriosis, ZEB1, Epithelial-mesenchymal transition (EMT), Progesterone resistance, Oestrogen signalling, TGF-β signalling, Non-coding RNAs, Fibrosis, miR-200 family, Single-cell transcriptomics

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AfD Victory in Sachsen-Anhalt: What Now?

The AfD's stunning victory in Sachsen-Anhalt with nearly 44% of the vote has left huge questions about who will form the government in the German state and whether the anti-AfD firewall will survive, says Eugyppius.

The post AfD Victory in Sachsen-Anhalt: What Now? appeared first on The Daily Sceptic.

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Global move away from oil could lead to conflict and migration, experts say

Researchers urge governments to help worst afflicted countries, such as Nigeria and Algeria, which rely on oil revenues for public services

Conflict, migration and economic upheaval will accompany the global move away from oil, unless governments act urgently to help the worst afflicted countries to cope, research has found.

Nigeria, Iran, Angola and Algeria are among the countries that will be severely affected, as they rely strongly on oil revenues for their government and provision of public services, but have little diversification and too little capital to cushion the blow.

Continue reading...

© Photograph: Sunday Alamba/AP

© Photograph: Sunday Alamba/AP

© Photograph: Sunday Alamba/AP

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In Minnesota, Words Matter More Than Rape

Shiloh Hendrix got a $1,000 fine and 200 hours of community service for using a racial slur. The Somali man who filmed her had rape charges dropped "in the interest of justice". Only in Minnesota, says Steven Tucker.

The post In Minnesota, Words Matter More Than Rape appeared first on The Daily Sceptic.

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Small Boat Record Smashed Again as 230 Migrants Smuggled Into Britain on ‘Mega-Dinghy’

A record 230 migrants have arrived in Britain on a single "mega-dinghy" – a floating deathtrap longer than a double-decker bus that could have earned people smugglers around £450,000 in one crossing.

The post Small Boat Record Smashed Again as 230 Migrants Smuggled Into Britain on ‘Mega-Dinghy’ appeared first on The Daily Sceptic.

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New IRA Terrorists Plan to Drive Migrants Out of Ireland with Campaign of Violence, Intelligence Officials Reveal

Intelligence officials are warning that the New IRA is plotting a campaign of violence aimed at driving migrants out of Ireland, including threatening to give some just 24 hours to leave the country.

The post New IRA Terrorists Plan to Drive Migrants Out of Ireland with Campaign of Violence, Intelligence Officials Reveal appeared first on The Daily Sceptic.

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Une étrange traînée rouge dans l'océan : cette baleine est filmée dans une scène jamais vue depuis les airs

Capturer la naissance d'une baleine à bosse relève presque de l'impossible. Pourtant, au large de l'Australie, un photographe animalier a filmé une scène exceptionnelle qui pourrait constituer une première mondiale.

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American Heiress ‘Murdered by Asylum Seeker Boyfriend’ Who Fled Ireland on One-Way Ticket

American heiress Jamey Carney was found dead in her Killarney home in July, after her teenage daughter discovered her body. Her Jordanian asylum seeker boyfriend is now the prime suspect.

The post American Heiress ‘Murdered by Asylum Seeker Boyfriend’ Who Fled Ireland on One-Way Ticket appeared first on The Daily Sceptic.

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Trump Administration Is Undoing Plans to Boost Workplace Heat Protections

The Biden administration took steps to shield workers from extreme temperatures. The Trump administration is taking a gentler approach with employers.

© Allison Joyce/Agence France-Presse — Getty Images

A delivery in Wilmington, N.C., this month. Heat is linked to hundreds of workplace deaths each year, but labor groups say the true toll is unknown because heat-related illnesses are not properly tracked or reported.
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Pakistan Blames Britain for “Grooming” and “Spoiling” Rochdale Rapist and Turning Him to Crime

Pakistan has blamed Britain for "grooming" and "spoiling" the ringleader of the Rochdale rape gang and turning him to crime, claiming he has "no connection to Pakistan whatsoever".

The post Pakistan Blames Britain for “Grooming” and “Spoiling” Rochdale Rapist and Turning Him to Crime appeared first on The Daily Sceptic.

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Family of 18 From Gaza Wins Human Rights Challenge to Allow Them to Come to Britain

A family of 18 from Gaza has won the right to come to Britain with "access to public funds" after winning a human rights challenge in the British courts.

The post Family of 18 From Gaza Wins Human Rights Challenge to Allow Them to Come to Britain appeared first on The Daily Sceptic.

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Small-Boat Migrants Who Gang-Raped Unconscious Woman on Beach Jailed for 60 Years

Three small-boat migrants who gang-raped an unconscious woman on Brighton beach in an "entirely predatory and callous attack" face deportation after being handed lengthy jail sentences today.

The post Small-Boat Migrants Who Gang-Raped Unconscious Woman on Beach Jailed for 60 Years appeared first on The Daily Sceptic.

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Asylum Accommodation is Ripping off the Taxpayer 

Asylum accommodation costs have more than trebled to over £15 billion and made a billionaire out of Clearsprings owner Graham King. This scandalous racket needs to end, says Madeleine Gillies.

The post Asylum Accommodation is Ripping off the Taxpayer  appeared first on The Daily Sceptic.

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How Particle Size Affects Rare Earth Ore Behavior

In a groundbreaking study published in Scientific Reports, a team of researchers led by Liu, D., Li, X., and Zhang, Z. has unveiled pivotal insights into the intricate mechanisms dictating how particle size influences the migration and deposition behaviors of weathered crust elution-deposited rare earth ores. This investigation probes deeply into the physicochemical principles and dynamic environmental interactions responsible for the distribution patterns of these valuable mineral resources, providing an unprecedented lens on their geochemical mobility.

The research tackles the challenge of understanding the migration pathways of rare earth elements (REEs) within the weathered crust, a layer significantly dictating ore generation. Central to their inquiry is the particle size of these ore constituents, which affects not only sediment transport dynamics but also the ore’s eventual deposition patterns through complex physicochemical interactions with surrounding media. The work bridges gaps between mineralogy, sedimentology, and geochemistry, offering a holistic view important for both scientific and industrial applications.

Their methodology encompassed a series of meticulously designed experiments and computational models to simulate natural conditions accurately. By varying particle sizes in controlled settings, the research team could monitor kinetic behaviors, adhesive interactions, and sedimentation rates of particles subjected to elution and migration processes. This allowed them to unravel size-dependent mechanisms underlying the spatial distribution and aggregation tendencies of REE particles within lateritic profiles.

In particular, the findings underscore the critical role of smaller particle fractions, which exhibited enhanced mobility due to lower gravitational settling but showed a propensity to adsorb onto mineral surfaces, thus influencing local concentration hotspots. Conversely, larger particles demonstrated reduced migration, primarily influenced by mechanical transport limits and gravitational forces, leading to more stable deposition zones. These differential behaviors directly affect the ore-forming processes and the quality of recoverable deposits.

Chemically, weathered crust environments present dynamic pH and redox conditions, which modulate particle surface charge, coagulation tendencies, and dissolution rates. The research elaborates how particle size accentuates these processes, with fine particles showing increased surface area promoting more extensive ion exchange and adsorption phenomena. Such micro-scale interactions substantially dictate macro-scale deposition patterns, impacting exploration strategies targeting rare earth mineralizations.

Moreover, the research extends its implications to understanding the environmental fate of rare earth elements beyond mining contexts. Rare earth particles, when mobilized through weathering, can traverse soil and water systems, posing ecological and human health risks. The particle size-dependent migration insights unveiled serve as crucial input for predictive environmental risk assessments and remediation planning around mining sites.

One of the most compelling aspects of the study is its integration of field data with laboratory results, ensuring real-world relevance. Samples collected across multiple deposit sites demonstrated consistent size-dependent migration tendencies, validating laboratory conclusions and revealing nuanced local variations driven by topographical and hydrological factors. Such data synthesis enhances the predictive power of their proposed migration and deposition models.

Their study also contributes to refining current geochemical theories related to elution-deposited ores, challenging prior assumptions that often overlooked particle size as a key variable. By pinpointing size-specific migration thresholds, the researchers clarify ore genesis mechanisms in weathered crusts, a region crucial for the global rare earth supply chains. This knowledge can revolutionize resource estimation practices, allowing for improved accuracy in reserve quantification.

Technologically, the researchers leveraged state-of-the-art microscopy and spectroscopic techniques to characterize particle morphologies, mineral compositions, and surface chemistry details. These sophisticated analytical methods provided high-resolution data necessary to comprehend how particle physical attributes interact with chemical environments, culminating in comprehensive migration and deposition profiles. This multidimensional approach epitomizes modern Earth sciences research.

The implications for mining engineering and metallurgy are profound. Understanding particle size effects on ore distribution allows for optimized beneficiation processes, enhancing the efficiency and economic viability of rare earth extraction. Tailored grinding, sorting, and sedimentation techniques can be developed based on specific ore particle sizes, reducing waste and environmental footprints. This research lays the foundation for such industry advances.

Further, the research opens avenues for innovative environmental management practices. By predicting rare earth particle transport pathways, stakeholders can implement targeted monitoring and control strategies to minimize ecological disturbances. This is particularly relevant in the context of expanding rare earth mining activities fueled by the global demand for clean energy technologies, where sustainable practices are paramount.

The interdisciplinary essence of the research, combining geology, chemistry, physics, and engineering, sets a benchmark for future studies addressing complex natural and anthropogenic processes influencing critical mineral resources. The clarity gained about particle size’s role in migration and deposition elucidates broader Earth system processes, benefiting multiple scientific domains and policy frameworks concerning resource stewardship.

In conclusion, Liu and colleagues’ study represents a significant advancement in our understanding of the fundamental processes underlying rare earth ore formation within weathered crust environments. Their comprehensive focus on particle size effects offers vital scientific and practical insights, opening new research horizons and contributing to the sustainable development of an indispensable resource underpinning modern technologies.


Subject of Research: Influence mechanism of particle size on the migration and deposition of weathered crust elution-deposited rare earth ores

Article Title: Research on the influence mechanism of particle size on the migration and deposition law of weathered crust elution-deposited rare earth ores

Article References:
Liu, D., Li, X., Zhang, Z. et al. Research on the influence mechanism of particle size on the migration and deposition law of weathered crust elution-deposited rare earth ores. Sci Rep (2026). https://doi.org/10.1038/s41598-026-56907-6

Image Credits: AI Generated

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“My 20 Year-Old Daughter Can’t Find a Job Because All the Work Has Gone to Migrants”

Sean Thomas says his 20 year-old daughter can't find a job – any job, stacking shelves, washing pots – because all the work has gone to migrants at a shocking ratio of 27 to one.

The post “My 20 Year-Old Daughter Can’t Find a Job Because All the Work Has Gone to Migrants” appeared first on The Daily Sceptic.

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