Maria Potes Bio 1615 Muhamed Jama April 10, 2014

Vascular endothelial growth factor (VEGF) concentrations are elevated in peritoneal fluid of women with endometriosis Endometriosis is present in about 10% of women of reproductive age and is one of the most common benign gynaecological conditions. Endometriosis can be defined as an appearance ranging from isolated peritoneal deposits to dense pelvic adhesions. The presence of angiogenic factors in the peritoneal environment is of great importance in endometriosis. Vascular endothelial growth factor (VEGF) is a angiogenic factor involved in physiological and pathological angiogenesis. Therefore, the purpose of this study was to investigate the presence of VEGF in peritoneal fluid and determine whether the concentration was different between women with or without endometriosis. In addition, the correlation between the potential fluid VEGF concentration and the severity of endometriosis was also investigated. Nineteen women without pelvic endometriosis and 24 women with endometriosis, aged between 25-40 years old, were used for this study. They had to be undergoing elective or diagnostic laparoscopy for infertility and could not be under any medication. All visible peritoneal fluid was collected by a Verres needle from the Pouch of Douglas. The phase of the menstrual cycle was established by histological dating of eutopic endometrium samples.

Peritoneal fluid VEGF concentrations were measured using a sandwich enzyme linked immunosorbent assay system (ELISA). 96-well plates were covered with a rabbit polyclonal anti-VEGF antibody raised against human VEGF, incubated over night and then blocked with bovine serum albumin in tris-buffered saline for two hours at room temperature. A substrate solution was then added for color development and thereafter sulphuric acid to stop the reaction. As a result, VEGF was detected in the peritoneal fluid of all women tested. It showed that the peritoneal fluid VEGF concentration in endometriosis patients was much higher (24.05 15 ng/ml) compared to the normal patient (13.25 7.2 ng/ml). The proliferative phase (33 13 ng/ml) was significantly higher than the secretory phase (10.72 5 ng/ml). This cyclic variation was not manifested in normal patients. Most patients with endometriosis were evaluated as having minimal to mild forms of endometriosis. These results were unable to determine if any correlation between the severity of the disease and the concentration of VEGF in the peritoneal fluid exists. In conclusion, VEGF is present in increased amounts in the peritoneal fluid of women with endometriosis. This could mean the possibility for the development of neovascularization within the peritoneal environment due to the increased amount of VEGF. Consequently, this could be crucial in the pathogenesis of endometriosis through the implantation and survival of the endometriotic tissue.