title: Leptin, its receptor and aromatase expression in deep infiltrating endometriosis.
abstract: BACKGROUND
  The aim of this study was to evaluate the leptin levels in the serum and peritoneal fluid (PF) and the protein expression in three different peritoneal ectopic implants in patients who underwent surgery for deep infiltrating endometriosis.
  
  
  METHODS
  All patients had been treated at the Department of Gynecology of the Pedro Ernesto University Hospital, Rio de Janeiro. The study group consisted of 15 patients who underwent surgery for adnexal masses and infertility, while the control group consisted of ten women who underwent surgery for tubal ligation. Peritoneal fluid and samples tissues were collected during surgery. Serum samples were obtained before anesthesia. In this study, the leptin levels in the serum and peritoneal fluid (PF) were evaluated by ELISA. The protein expression of leptin and its receptors (ObR) and aromatase enzyme were evaluated by Western blot analysis of the intestine, uterosacral ligament and vaginal septum in the ectopic implants. The t-test and one-way ANOVA with Holm-Sìdak post-test were used, and p < 0.05 was considered to be statistically significant.
  
  
  RESULTS
  Compared to the controls, the serum leptin levels (control = 14.7 ng/mL ± 2.63, endometriosis = 19.2 ng/mL ± 1.84, p < 0.0001) were increased, while in PF, there was no difference (control = 6.68 ng/mL ± 0.43, endometriosis = 7.71 ng/mL ± 0.59, p = 0.18). Comparing women with and without ovarian implants, the leptin levels in both the serum and PF were significantly higher in women without ovarian implants (serum: with ovarian implant = 15.85 ± 1.99; without ovarian implant = 23.14 ± 2.60; ng/mL, p = 0.04; PF: with ovarian implant = 4.28 ± 1.30; without ovarian implant = 11.18 ± 2.98;ng/mL, p = 0.048). The leptin, ObR and aromatase protein expression levels were increased in lesions in the vaginal septum and were decreased in the intestine lesions.
  
  
  CONCLUSIONS
  This study reports several interesting associations between the leptin levels in serum, peritoneal fluid, and tissue samples and the localization of the ectopic endometrium. Although this study does not provide a clear picture of the role of leptin in the development and progression of peritoneal implants, it contributed new data that might be useful to elucidating the enigma that is the role of leptin in endometriosis disease.
authors.affiliation: Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil. goncalves.hf@gmail.com.
authors.forename: Helder F
authors.initials: HF
authors.lastname: Gonçalves
authors.affiliation: Department of Gynecology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Carolina
authors.initials: C
authors.lastname: Zendron
authors.affiliation: Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Fernanda S
authors.initials: FS
authors.lastname: Cavalcante
authors.affiliation: Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Verônica
authors.initials: V
authors.lastname: Aiceles
authors.affiliation: Department of Gynecology, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Marco Aurélio P
authors.initials: MA
authors.lastname: Oliveira
authors.affiliation: Departament of Morfology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
authors.forename: Jorge Henrique M
authors.initials: JH
authors.lastname: Manaia
authors.affiliation: Departament of Morfology, Biomedical Institute, Fluminense Federal University, Niterói, Rio de Janeiro, Brazil.
authors.forename: Márcio A
authors.initials: MA
authors.lastname: Babinski
authors.affiliation: Laboratory of Morphometry, Metabolism and Cardiovascular Disease, Biomedical Center, Institute of Biology, Department of Anatomy, State University of Rio de Janeiro, Rio de Janeiro, Brazil.
authors.forename: Cristiane F
authors.initials: CF
authors.lastname: Ramos
mesh_terms: D000328:Adult; D001141:Aromatase / Q000097:blood / Q000235:genetics*; D001202:Ascitic Fluid / Q000378:metabolism; D015992:Body Mass Index; D004715:Endometriosis / Q000097:blood / Q000235:genetics* / Q000473:pathology; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000235:genetics / Q000473:pathology; D010535:Laparoscopy; D020738:Leptin / Q000097:blood / Q000235:genetics*; D010537:Peritoneum / Q000378:metabolism / Q000473:pathology; D054411:Receptors, Leptin / Q000097:blood / Q000235:genetics*; D014621:Vagina / Q000378:metabolism / Q000473:pathology
chemical_list: C515448:LEPR protein, human; D020738:Leptin; D054411:Receptors, Leptin; D001141:Aromatase