title: Potential involvement of hemoglobin and heme in the pathogenesis of peritoneal endometriosis.
abstract: OBJECTIVE
  To test whether hemoglobin may accumulate in the peritoneal cavity in case of endometriosis and to assess whether heme oxygenases (HO), detoxifying heme, are expressed in ectopic endometrium and peritoneal cells.
  
  
  METHODS
  Prospective study involving patients with and without endometriosis.
  
  
  METHODS
  Department of gynecology in a university hospital.
  
  
  METHODS
  Seventy-six patients undergoing laparoscopy for tubal sterilization or infertility and/or pelvic pain.
  
  
  METHODS
  Collection of peritoneal fluid (PF), blood samples, and biopsies from endometrium and peritoneum.
  
  
  METHODS
  Measurement of free hemoglobin and its byproduct, total and direct bilirubin, in serum and PF and analysis of HO-1 and HO-2 expression in biopsies by reverse transcription polymerase chain reaction and semiquantitative immunohistochemistry.
  
  
  RESULTS
  Higher levels of hemoglobin were found in the PF of patients with endometriosis. There was no concomitant increase in bilirubin concentrations in the PF, and HO-1 was poorly expressed in peritoneal mesothelium and macrophages. Heme oxygenase-1 and HO-2 were strongly expressed in ectopic endometrium, especially in red lesions.
  
  
  CONCLUSIONS
  Our results suggest that heme may be involved in the pathogenesis and/or development of endometriosis and that the HO system, although expressed, might be insufficient to detoxify heme in women with endometriosis.
authors.affiliation: Department of Gynecology, Université Catholique de Louvain, Brussels, Belgium.
authors.forename: Anne
authors.initials: A
authors.lastname: Van Langendonckt
authors.forename: Françoise
authors.initials: F
authors.lastname: Casanas-Roux
authors.forename: Marie-Madeleine
authors.initials: MM
authors.lastname: Dolmans
authors.forename: Jacques
authors.initials: J
authors.lastname: Donnez
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry; D001663:Bilirubin / Q000097:blood / Q000378:metabolism; D001706:Biopsy; D018076:DNA, Complementary / Q000235:genetics / Q000378:metabolism; D004715:Endometriosis / Q000097:blood / Q000209:etiology / Q000378:metabolism*; D005260:Female; D006418:Heme / Q000378:metabolism*; D006419:Heme Oxygenase (Decyclizing) / Q000096:biosynthesis / Q000235:genetics / Q000378:metabolism; D051547:Heme Oxygenase-1; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007150:Immunohistochemistry; D008565:Membrane Proteins; D010532:Peritoneal Diseases / Q000097:blood / Q000209:etiology / Q000378:metabolism*; D011446:Prospective Studies; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D020133:Reverse Transcriptase Polymerase Chain Reaction; D018709:Statistics, Nonparametric
chemical_list: D018076:DNA, Complementary; D006454:Hemoglobins; D008565:Membrane Proteins; D012333:RNA, Messenger; D006418:Heme; C496541:HMOX1 protein, human; D006419:Heme Oxygenase (Decyclizing); D051547:Heme Oxygenase-1; C105245:heme oxygenase-2; D001663:Bilirubin