Paracrine changes in the peritoneal environment of women with endometriosis

Citation
W. Kupker et al., Paracrine changes in the peritoneal environment of women with endometriosis, HUM REP UPD, 4(5), 1998, pp. 719-723
Citations number
16
Categorie Soggetti
Reproductive Medicine
Journal title
HUMAN REPRODUCTION UPDATE
ISSN journal
13554786 → ACNP
Volume
4
Issue
5
Year of publication
1998
Pages
719 - 723
Database
ISI
SICI code
1355-4786(199809/10)4:5<719:PCITPE>2.0.ZU;2-7
Abstract
During the past decade, macrophage-derived substances such as prostanoids, cytokines, growth factors and angiogenic factors have been detected in the peritoneal fluid of women with endometriosis. In particular, growth-promoti ng and angiogenic factors are considered to be substantially involved in th e pathogenesis of endometriosis. In this study, vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-beta) and intercellula r adhesion molecule 1 (ICAM-1), substances recently detected in the periton eal fluid of women with endometriosis, were assessed with regard to their c oncentrations in different stages of endometriosis and changes of the perit oneal paracrine activity after medical treatment with a gonadotrophin relea sing hormone agonist (GnRHa). Peritoneal fluid was obtained from patients w ith endometriosis during laparoscopy before and after a 4-month treatment w ith a GnRHa. VEGF; TGF-P and ICAM-1 could be detected in all women presenti ng with various stages of active endometriosis. After GnRHa therapy, all pa tients showed significant decreases in mean concentrations of VEGF (194 +/- 77 pg/ml), TGF-beta (902 +/- 273 pg/ml) and ICAM-1 (157 +/- 52 ng/ml). Pat ients with stage III and IV endometriosis (according to the rAFS score) had much higher concentrations of VEGF and TGF-beta before treatment compared with those patients with mild endometriosis (rAFS stages I and II). The mos t striking decrease in concentration was for TGF-beta, from 902 pg/ml befor e to 273 pg/ml after therapy, These results indicate an important role for paracrine activity in the establishment and maintenance of endometriosis, I ndeed, treatment with a GnRHa may reduce paracrine activity in the peritone al cavity via hypo-oestrogenism and provide proof of successful therapy.