title: The plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 are elevated in patients with endometriosis.
abstract: BACKGROUND
  Enzyme matrix metalloproteinase-9 is a member of the matrix metalloproteinase family, which is critical to normal tissue remodelling during embryogenesis and wound healing. In patients with endometriosis, increased expression and activity of matrix metalloproteinase-9 have been observed in ectopic endometrium, but the plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 in patients with endometriosis and their relation to disease severity have not been clear. The aim of the study was to investigate the concentrations of matrix metalloproteinase-9 in plasma and peritoneal fluid of patients with endometriosis.
  
  
  METHODS
  A prospective case-control study was conducted in Jinan Military General Hospital between January 2010 and December 2013. Fifty patients with proven endometriosis and 26 endometriosis-free controls were enrolled in this study. Patients with endometriosis were evaluated and divided into moderate/severe endometriosis group (stage I-II, n = 26) and minimal/mild endometriosis group (stage III-IV, n = 24) according to the revised criteria of the American Society for Reproductive Medicine. Blood samples and peritoneal fluid were obtained from both patients and controls. Matrix metalloproteinase-9 was measured using enzyme-linked immunosorbent assay in plasma and peritoneal fluid. The concentration of matrix metalloproteinase-9 between different groups was compared and its correlation to disease severity was analysed.
  
  
  RESULTS
  Plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 in patients with endometriosis were higher than that in controls. In addition, those patients with moderate/severe endometriosis had significantly higher plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 compared to those with minimal/mild endometriosis. Matrix metalloproteinase-9 concentrations in plasma and peritoneal fluid were both positively correlated with severity of endometriosis and plasma matrix metalloproteinase-9 concentrations had a positive correlation with peritoneal fluid matrix metalloproteinase-9 concentrations in patients with endometriosis.
  
  
  CONCLUSIONS
  Increased concentrations of plasma and peritoneal fluid concentrations of matrix metalloproteinase-9 appear to be associated with disease severity of endometriosis and may serve as an alternative biomarker to determine disease severity of endometriosis.
authors.affiliation: Reproductive Medicine Centre of Jinan Military General Hospital, Jinan, P.R. China.
authors.forename: Haiping
authors.initials: H
authors.lastname: Liu
authors.affiliation: Reproductive Medicine Centre of Jinan Military General Hospital, Jinan, P.R. China.
authors.forename: Jianye
authors.initials: J
authors.lastname: Wang
authors.affiliation: Reproductive Medicine Centre of Jinan Military General Hospital, Jinan, P.R. China.
authors.forename: Haiyu
authors.initials: H
authors.lastname: Wang
authors.affiliation: Reproductive Medicine Centre of Jinan Military General Hospital, Jinan, P.R. China.
authors.forename: Ning
authors.initials: N
authors.lastname: Tang
authors.affiliation: Reproductive Medicine Centre of Jinan Military General Hospital, Jinan, P.R. China.
authors.forename: Yunfei
authors.initials: Y
authors.lastname: Li
authors.affiliation: Reproductive Medicine Centre of Jinan Military General Hospital, Jinan, P.R. China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Zhang
authors.affiliation: Reproductive Medicine Centre of Jinan Military General Hospital, Jinan, P.R. China haotianyu63@sina.com.
authors.forename: Tianyu
authors.initials: T
authors.lastname: Hao
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000201:enzymology*; D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D004715:Endometriosis / Q000097:blood* / Q000201:enzymology / Q000473:pathology; D005260:Female; D006801:Humans; D020780:Matrix Metalloproteinase 9 / Q000097:blood*; D055815:Young Adult
chemical_list: D015415:Biomarkers; C579270:MMP9 protein, human; D020780:Matrix Metalloproteinase 9
keywords: Endometriosis; biological markers; matrix metalloproteinase-9; peritoneal fluid; plasma