Microvascular density, vascular endothelial growth factor A, and its receptors in endometrial blood vessels in patients with menorrhagia.
OBJECTIVE
To analyze the expression of vascular endothelial growth factor A (VEGF-A) and receptors (VEGFR-1 and VEGFR-2) in endometrial blood vessels, as well as microvascular density (MVD), in endometrial biopsy samples from idiopathic menorrhagia patients.


METHODS
Prospective clinical study.


METHODS
University hospital, unit of gynecology.


METHODS
Twenty-four patients with idiopathic menorrhagia and 18 healthy fertile women.


METHODS
Blood sampling for hormone measurement, hysteroscopy, and endometrial biopsy sampling. Endometrial biopsy samples were used for immunohistochemistry assessments and image analysis of stained endothelial structures for VEGF-A, VEGFR-1, VEGFR-2, and CD34.


METHODS
Appearance of the endometrial vascular immunoreactivity for VEGF-A, VEGFR-1, and VEGFR-2, MVD and computer-assisted stereological analysis of immunoassayed blood vessels.


RESULTS
Although the MVD did not differ between patients and controls, we observed that vascular expression of VEGF-A, VEGFR-1, and VEGFR-2 in capillaries was 1.8-fold, 1.8-fold, and 2.0-fold higher, respectively, in the menorrhagia group when assessed as the number of stained capillaries per unit area. There were also a twofold higher number of arterioles, which were VEGFR-2 positive in the menorrhagia group.


CONCLUSIONS
Up-regulation of VEGF-A and receptors VEGFR-1 and VEGFR-2 in capillaries in menorrhagia could be involved in abnormal endometrial vascular structure and permeability.
Mints
Miriam
M
Division of Obstetrics and Gynaecology, Department of Clinical Science, Karolinska Institutet, Huddinge University Hospital, Stockholm, Sweden. miriam.mints@telia.com
Blomgren
Bo
B
Falconer
Christian
C
Fianu-Jonasson
Aino
A
Palmblad
Jan
J
D000328:Adult; D001160:Arterioles / Q000737:chemistry / Q000378:metabolism / Q000502:physiology; D002196:Capillaries / Q000737:chemistry / Q000378:metabolism / Q000502:physiology; D002199:Capillary Permeability / Q000502:physiology; D004717:Endometrium / Q000098:blood supply* / Q000737:chemistry / Q000378:metabolism; D005260:Female; D006801:Humans; D008595:Menorrhagia / Q000378:metabolism* / Q000503:physiopathology; D008833:Microcirculation / Q000737:chemistry / Q000378:metabolism / Q000502:physiology; D008875:Middle Aged; D011446:Prospective Studies; D018709:Statistics, Nonparametric; D015854:Up-Regulation / Q000502:physiology; D042461:Vascular Endothelial Growth Factor A / Q000096:biosynthesis* / Q000502:physiology; D040281:Vascular Endothelial Growth Factor Receptor-1 / Q000096:biosynthesis* / Q000502:physiology; D040301:Vascular Endothelial Growth Factor Receptor-2 / Q000096:biosynthesis* / Q000502:physiology
D042461:Vascular Endothelial Growth Factor A; D040281:Vascular Endothelial Growth Factor Receptor-1; D040301:Vascular Endothelial Growth Factor Receptor-2