title: Reduced hemopexin levels in peritoneal fluid of patients with endometriosis.
abstract: OBJECTIVE
  To study altered hemopexin concentrations in peritoneal fluid (PF) samples from patients with endometriosis. Recent data implicate a role of altered iron metabolism in endometriosis patients. Hemopexin is the major transport protein for heme. Like iron, heme exposure to the epithelial surface can provoke oxidative stress on the peritoneal epithelium. Therefore, altered hemopexin concentrations and heme scavenging in PF might play a role in the pathophysiology of endometriosis.
  
  
  METHODS
  Prospective explorative study.
  
  
  METHODS
  Academic tertiary care center.
  
  
  METHODS
  Eighty symptomatic patients scheduled for laparoscopy for the diagnosis and/or therapy of endometriosis.
  
  
  METHODS
  Aspiration of PF samples during laparoscopy.
  
  
  METHODS
  Hemopexin and heme concentration in PF.
  
  
  RESULTS
  At laparoscopy, 47 of 80 (58.8%) patients exhibited endometriosis, and 33 (41.2%) were proven disease-free (CO). By means of ELISA significantly lower concentrations of hemopexin in the samples from patients with endometriosis (endometriosis 0.377 ± 0.16 mg/mL) compared with controls (disease-free 0.479 ± 0.20 mg/mL) could be demonstrated. Heme levels in the samples were not significantly different between groups (endometriosis 9.130 ± 6.124 μM and disease-free 9.990 ± 4.485 μM). There was no significant correlation between heme and hemopexin levels (Pearson's correlation coefficient r = -0.146). Demographic data between the groups were comparable.
  
  
  CONCLUSIONS
  These data provide further evidence that hemopexin is significantly down-regulated in PF samples from patients with endometriosis compared with controls. This study confirms recent findings in two-dimensional gel electrophoresis demonstrating a down-regulation of hemopexin in PF from patients with endometriosis in a larger series of samples.
authors.affiliation: Department of Obstetrics and Gynecology, Medical Faculty of the RWTH Aachen University, Aachen, Germany. mwoelfler@ukaachen.de
authors.forename: Monika M
authors.initials: MM
authors.lastname: Wölfler
authors.forename: Ivo M
authors.initials: IM
authors.lastname: Meinhold-Heerlein
authors.forename: Corinna
authors.initials: C
authors.lastname: Henkel
authors.forename: Werner
authors.initials: W
authors.lastname: Rath
authors.forename: Joseph
authors.initials: J
authors.lastname: Neulen
authors.forename: Nicolai
authors.initials: N
authors.lastname: Maass
authors.forename: Karen
authors.initials: K
authors.lastname: Bräutigam
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry / Q000378:metabolism* / Q000473:pathology; D015536:Down-Regulation; D004715:Endometriosis / Q000378:metabolism* / Q000473:pathology / Q000601:surgery; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D006418:Heme / Q000032:analysis / Q000378:metabolism; D006466:Hemopexin / Q000032:analysis / Q000378:metabolism*; D006801:Humans; D010535:Laparoscopy; D010049:Ovarian Diseases / Q000378:metabolism / Q000473:pathology / Q000601:surgery; D055815:Young Adult
chemical_list: D006418:Heme; D006466:Hemopexin
keywords: Endometriosis; heme; hemopexin; iron metabolism; peritoneal fluid