title: Polymorphism in vitamin D-binding protein as a genetic risk factor in the pathogenesis of endometriosis.
abstract: BACKGROUND
  Previous studies have implicated a deficiency in the inflammatory response in women who develop endometriosis. The specific immunological deficits have not been completely elucidated.
  
  
  OBJECTIVE
  Our objective was to identify differences in protein expression in serum that might shed light on the pathophysiology of endometriosis.
  
  
  METHODS
  This cross-sectional study of women undergoing laparoscopy between 2003 and 2005 took place at a university medical center.
  
  
  METHODS
  Patients included consenting women age 18-49 yr undergoing surgery for pain and/or infertility or elective tubal ligation. Women with acute or chronic medical conditions were excluded.
  
  
  METHODS
  Blood was collected preoperatively.
  
  
  METHODS
  Proteomic analysis of serum was done using two-dimensional difference gel electrophoresis.
  
  
  RESULTS
  We found 25 protein spots with a significant difference in abundance between women with endometriosis and controls, including acute-phase proteins and complement components. The abundance of vitamin D-binding protein was higher in all endometriosis pools by a factor of approximately 3 compared with the control pool (P < 0.02). Analysis of specific allele products using nano-scale liquid chromatography-electrospray ionization-mass spectrometry indicated that it was the GC*2 allele product that was in greater concentration in serum pools, as well as in single validation samples, in women with endometriosis (P = 0.006). In contrast to the GC*1 allele product, which is readily converted to a potent macrophage factor (Gc protein-derived macrophage-activating factor), the GC*2 allele product undergoes practically no such conversion.
  
  
  CONCLUSIONS
  We speculate that the inability to sufficiently activate macrophages' phagocytotic function in those carrying the GC*2 polymorphism (more prevalent in endometriosis) may allow endometriotic tissues to implant in the peritoneal cavity. Future studies evaluating specific vitamin D-binding protein polymorphisms as a risk factor for endometriosis in larger populations of women are warranted.
authors.affiliation: Department of Gynecologic Endocrinology and Reproductive Medicine, Innsbruck Medical University, Innsbruck, Austria.
authors.forename: Klaus
authors.initials: K
authors.lastname: Faserl
authors.forename: Georg
authors.initials: G
authors.lastname: Golderer
authors.forename: Leopold
authors.initials: L
authors.lastname: Kremser
authors.forename: Herbert
authors.initials: H
authors.lastname: Lindner
authors.forename: Bettina
authors.initials: B
authors.lastname: Sarg
authors.forename: Ludwig
authors.initials: L
authors.lastname: Wildt
authors.forename: Beata
authors.initials: B
authors.lastname: Seeber
mesh_terms: D000483:Alleles; D002853:Chromatography, Liquid; D003430:Cross-Sectional Studies; D015180:Electrophoresis, Gel, Two-Dimensional; D004715:Endometriosis / Q000097:blood* / Q000209:etiology; D005260:Female; D006801:Humans; D013058:Mass Spectrometry; D011110:Polymorphism, Genetic; D012307:Risk Factors; D014809:Vitamin D-Binding Protein / Q000032:analysis / Q000097:blood*
chemical_list: D014809:Vitamin D-Binding Protein