A priori implantation potential does not differ in eutopic endometrium of patients with and without endometriosis

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This study compared VEGF expression and angiogenic induction in eutopic endometrial fragments from endometriosis patients and controls transplanted to a chicken chorioallantoic membrane, finding no significant differences.

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This experimental prospective study compared angiogenic induction potential, focusing on VEGF mRNA expression and protein localization, in eutopic endometrial tissue from 10 women with endometriosis versus 6 healthy, ovulating controls, using endometrial fragments transplanted onto the chicken chorioallantoic membrane (CAM) and re-cultured for 0–96 hours. VEGF mRNA rose significantly in endometrial fragments from both groups, with VEGF protein expressed in glands and stroma, and vessel index increased versus native CAM controls. However, endometriosis and control samples showed no significant differences in VEGF expression or angiogenic induction in the CAM assay. A key limitation is the small sample size and that the CAM transplantation model may reflect only part of the implantation process, with the authors concluding implantation may be driven by external regulating influences on exfoliated endometrial tissue. This paper is centrally about endometriosis — it tests whether eutopic (in-patient) endometrium differs in VEGF-mediated implantation/angiogenic potential between women with and without endometriosis.

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Abstract

BackgroundIn endometriosis, angiogenesis is a crucial step for implantation of the exfoliates. A priori potential to induce angiogenesis by vascular endothelial growth factor (VEGF) expression was compared in eutopic endometrium of patients with and without endometriosis to discriminate the pivotal pathogenic step that differs in endometriosis.MethodsIn an experimental prospective study, endometrium samples were obtained from endometriosis patients (n=10) and from healthy, ovulating women as controls (n=6) undergoing curettage and laparoscopy for benign gynaecological conditions at the Aachen University Hospital, Aachen, Germany. Endometrial fragments were transplanted to the chicken chorioallantoic membrane (CAM) and re-explanted after 0, 24, 48, 72 and 96 h of cultivation for analysis. The main outcome measure was VEGF mRNA expression and protein localisation in endometrial fragments as parameters of angiogenic induction that was quantified by the vessel index.ResultsVEGF mRNA expression increased significantly in endometrial fragments of endometriosis and control patients (p<0.05). Protein is expressed in the glands and endometrial stroma. The vessel index is significantly elevated compared with native CAM controls. Endometrial fragments of endometriosis and control patients showed no significant differences in VEGF expression or angiogenic induction.ConclusionsEutopic endometrial fragments of patients with and without endometriosis do not differ in their VEGF expression or angiogenic activity in the CAM assay. Implantation is obviously decided by external regulating influences on the exfoliates.
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Abstract

Background In endometriosis, angiogenesis is a crucial step for implantation of the exfoliates. A priori potential to induce angiogenesis by vascular endothelial growth factor (VEGF) expression was compared in eutopic endometrium of patients with and without endometriosis to discriminate the pivotal pathogenic step that differs in endometriosis.

Methods

In an experimental prospective study, endometrium samples were obtained from endometriosis patients (n=10) and from healthy, ovulating women as controls (n=6) undergoing curettage and laparoscopy for benign gynaecological conditions at the Aachen University Hospital, Aachen, Germany. Endometrial fragments were transplanted to the chicken chorioallantoic membrane (CAM) and re-explanted after 0, 24, 48, 72 and 96 h of cultivation for analysis. The main outcome measure was VEGF mRNA expression and protein localisation in endometrial fragments as parameters of angiogenic induction that was quantified by the vessel index.

Results

VEGF mRNA expression increased significantly in endometrial fragments of endometriosis and control patients (p<0.05). Protein is expressed in the glands and endometrial stroma. The vessel index is significantly elevated compared with native CAM controls. Endometrial fragments of endometriosis and control patients showed no significant differences in VEGF expression or angiogenic induction.

Conclusions

Eutopic endometrial fragments of patients with and without endometriosis do not differ in their VEGF expression or angiogenic activity in the CAM assay. Implantation is obviously decided by external regulating influences on the exfoliates. Similar content being viewed by others

References

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Acknowledgements

The authors are grateful to Inga Jensen for her technical assistance and Sven Stanzel for his expert advice on the statistical analysis. This work was supported by a grant from the Deutsche Forschungsgemeinschaft (MA 2391/1-1) to E.-M.W., P.K., and E.M., Germany. Author information Authors and Affiliations Corresponding author Rights and permissions About this article Cite this article Gescher, D.M., Siggelkow, W., Meyhoefer-Malik, A. et al. A priori implantation potential does not differ in eutopic endometrium of patients with and without endometriosis. Arch Gynecol Obstet 272, 117–123 (2005). https://doi.org/10.1007/s00404-004-0688-9 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-004-0688-9

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Endometrium Animals Chick Embryo Chorioallantoic Membrane Chorioallantoic Membrane Endometriosis Endometriosis Endometrium Endometrium Endometrium Endometrium Female Humans Immunohistochemistry Neovascularization, Pathologic Neovascularization, Pathologic Neovascularization, Physiologic Neovascularization, Physiologic Prospective Studies

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