title: Increased pregnancy-associated plasma protein-A (PAPP-A) concentrations in peritoneal fluid of women with endometriosis.
abstract: OBJECTIVE
  Pregnancy-associated plasma protein-A (PAPP-A) belongs to a group of glycoproteins isolated from extracts of human placenta. Healthy ovarian and uterine tissues are also known to express PAPP-A. We hypothesized that PAPP-A levels might also be elevated in the peritoneal fluid (PF) of women with endometriosis, and examined variations in PF PAPP-A during the menstrual cycle and with the severity of the disease.
  
  
  METHODS
  PF PAPP-A were measured in 60 women with endometriosis and 38 women without endometriosis using a high-sensitivity immunofluorometric assay.
  
  
  RESULTS
  We found that the mean level of PAPP-A was higher in PF from patients with endometriosis than controls (p = 0.003). Furthermore, significant correlation was found between the stages of endometriosis and the levels of PAPP-A in these patients (r = 0.39, p = 0.009). The concentrations of PAPP-A in PF were significantly higher in the secretory phase than the proliferative phase of the menstrual cycle in both women with and without endometriosis (p = 0.009 and P = 0.002, respectively). Finally, among the controls, women undergoing tubal ligation had significantly lower mean PF levels of PAPP-A than women with infertility or pelvic pain (p = 0.001).
  
  
  CONCLUSIONS
  We conclude that PF levels of PAPP-A vary during the menstrual cycle, and are highest in the secretory phase. We also find that PF PAPP-A levels are significantly increased in women with endometriosis, and that the degree of elevation corresponds to the extent of disease.
authors.affiliation: Yale University School of Medicine, Department of Obstetrics and Gynecology, Division of Reproductive Endocrinology, New Haven, CT 06520-8063, USA. aydin.arici@yale.edu
authors.forename: Aydin
authors.initials: A
authors.lastname: Arici
authors.forename: Ioannis
authors.initials: I
authors.lastname: Matalliotakis
authors.forename: Anastasia
authors.initials: A
authors.lastname: Goumenou
authors.forename: Georgios
authors.initials: G
authors.lastname: Koumantakis
authors.forename: Yvoni
authors.initials: Y
authors.lastname: Fragouli
authors.forename: Neal G
authors.initials: NG
authors.lastname: Mahutte
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000378:metabolism*; D004715:Endometriosis / Q000378:metabolism*; D005260:Female; D005455:Fluorescent Antibody Technique; D006801:Humans; D008597:Menstrual Cycle / Q000378:metabolism; D011266:Pregnancy-Associated Plasma Protein-A / Q000378:metabolism*
chemical_list: D011266:Pregnancy-Associated Plasma Protein-A