Vascular endothelial growth factor and endometriotic angiogenesis

Peritoneal endometriosis is a significant debilitating gynaecological probl em of widespread prevalence. It is now generally accepted that the pathogen esis of peritoneal endometriosis involves the implantation of exfoliated en dometrium. Essential for its survival is the generation and maintenance of an extensive blood supply both within and surrounding the ectopic tissue. T he vascular endothelial growth factor (VEGF) family of angiogenic molecules is involved in both physiological angiogenesis, and a number of pathologic al conditions that are characterized by excessive angiogenesis. Increasing evidence suggests that the VEGF family may also be involved with both the a etiology and maintenance of peritoneal endometriosis. Sources of this facto r include the eutopic endometrium, ectopic endometriotic tissue and periton eal fluid macrophages, Important to its aetiology is the correct peritoneal environment in which the exfoliated endometrium is seeded and implants. Es tablished ectopic tissue is then dependent on the peritoneal environment fo r its survival, an environment that supports angiogenesis, Our increasing k nowledge of the involvement of the VEGF family in endometriotic angiogenesi s raises the possibility of novel approaches to its medical management, wit h particular focus on the anti-angiogenic control of the action of VEGF.