Signs of reduced angiogenic activity after surgical removal of deeply infiltrating endometriosis.
OBJECTIVE
To study the concentrations of vascular endothelial growth factor A (VEGF-A), soluble vascular endothelial growth factor receptors-1 and -2 (sVEGFR-1 and -2), angiogenin, and angiopoietin-2 (Ang-2) in serum and peritoneal fluid from healthy controls and women with advanced endometriosis. Further, we addressed the question of whether surgical removal of endometriotic lesions was associated with normalization of the serum concentrations of the same markers.


METHODS
Patients with endometriosis before and after surgery were compared with control patients.


METHODS
University Hospital.


METHODS
Twenty-one healthy controls and 32 women with advanced endometriosis.


METHODS
In women with endometriosis we performed surgical removal of endometriotic lesions using laparoscopy.


METHODS
Data on serum and peritoneal fluid concentrations of selected markers in healthy controls and women with endometriosis before surgery and in serum 5 to 7 days after surgery.


RESULTS
Women with endometriosis had elevated levels of VEGF-A, sVEGFR-1, and Ang-2 in serum and all studied markers in peritoneal fluid compared with healthy controls. Surgical removal of endometriotic lesions resulted in decreased serum levels of pro-angiogenic VEGF-A and increased levels of sVEGFR-2 that negatively regulates the action of VEGF.


CONCLUSIONS
Women with advanced endometriosis have serum and peritoneal fluid concentrations of several factors involved in the regulation of angiogenesis that differ from those in healthy women, and these changes at least partly normalize within a week after surgical removal of the endometriotic lesions.
Bourlev
Vladimir
V
Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden.
Iljasova
Natalia
N
Adamyan
Leyla
L
Larsson
Anders
A
Olovsson
Matts
M