title: Vascular endothelial growth factor production by circulating immune cells is elevated in ovarian hyperstimulation syndrome.
abstract: BACKGROUND
  Ovarian hyperstimulation syndrome (OHSS) is an iatrogenic disease manifesting itself by ovarian enlargement and massive ascites with increased peritoneal capillary permeability. Although vascular endothelial growth factor (VEGF) is considered to play the main role in developing OHSS, its precise mechanism remains unclear. In this study, we examined possible roles of circulating immune cells in the pathogenesis of OHSS.
  
  
  METHODS
  Peripheral blood mononuclear cells (PBMC) and plasma were collected from healthy non-pregnant volunteers and from patients receiving ovulation induction for IVF. PBMC were cultured for 48 h. Plasma and/or medium concentrations of VEGF, estradiol and progesterone were measured using enzyme-linked immunosorbent assay and radioimmunoassay kits.
  
  
  RESULTS
  VEGF production by cultured PBMC and plasma concentrations of VEGF taken from patients with early onset OHSS (n = 12) were significantly higher than those in non-pregnant volunteers and patients without OHSS whose oocyte retrieval rates were similar to that of OHSS patients. OHSS patients were further classified into a high plasma VEGF concentration group and a high culture medium VEGF group. There was no significant correlation among VEGF production by PBMC and plasma concentration of VEGF, estradiol or progesterone.
  
  
  CONCLUSIONS
  Although mechanistic evidence has not been provided, our study does provide new evidence to suggest that circulating immune cells are involved in the pathogenesis of OHSS via VEGF production.
authors.affiliation: Department of Gynecology and Obstetrics, Faculty of Medicine, Kyoto University, Kyoto 606-8507, Japan.
authors.forename: Kenzo
authors.initials: K
authors.lastname: Kosaka
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Fujiwara
authors.forename: Shinya
authors.initials: S
authors.lastname: Yoshioka
authors.forename: Shingo
authors.initials: S
authors.lastname: Fujii
mesh_terms: D000328:Adult; D005260:Female; D012739:Gonadal Steroid Hormones / Q000097:blood; D006801:Humans; D007963:Leukocytes, Mononuclear / Q000276:immunology*; D016471:Ovarian Hyperstimulation Syndrome / Q000276:immunology*; D042461:Vascular Endothelial Growth Factor A / Q000097:blood / Q000378:metabolism*
chemical_list: D012739:Gonadal Steroid Hormones; D042461:Vascular Endothelial Growth Factor A