Spielt VEGF bei den zyklischen Zervixveränderungen eine Rolle?

In: Geburtshilfe und Frauenheilkunde · 2001 · vol. 61(9) , pp. 671–675 · doi:10.1055/s-2001-17390 · W2092423307
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Researchers investigated the role of vascular endothelial growth factor in cyclic cervical changes by analyzing its presence in endocervical tissue and mucus throughout the menstrual cycle.

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This study investigated the expression of vascular endothelial growth factor (VEGF) in endocervical tissue and mucus from 20 premenopausal women undergoing hysterectomy. Researchers analyzed samples across the proliferative, periovulatory, and secretory phases of the menstrual cycle using immunohistochemistry and enzyme-linked immunosorbent assays. The results demonstrated that VEGF levels in cervical mucus peaked significantly during the periovulatory phase, coinciding with increased staining in the apical epithelium and stroma, which may facilitate cervical opening and mucus liquefaction. Relevance to endometriosis: VEGF is listed in the references as a regulator of angiogenesis in endometrial carcinoma and potentially in the pathogenesis of endometriosis, though this specific paper focuses on normal cyclic cervical changes rather than endometriosis or adenomyosis pathology.

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Abstract

Periovulatorisch kommt es zu einer Muttermundsöffnung auf 1 - 2 cm und zu einer Verflüssigung des Zervixschleims. Hierfür könnte der vascular endothelial growth factor (VEGF), der angiogenetisch wirkt und die Gefäßpermeabilität erhöht, eine entscheidende Rolle spielen. Daher haben wir VEGF in endozervikalen Gewebeproben und im Zervixschleim während des Menstruationszyklus untersucht.
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Objective

Around the time of ovulation the cervix opens and the cervical mucus liquefies. Vascular endothelial growth factor (VEGF), a potent inductor of vascular permeability, may play a role in these changes. We examined VEGF in cervical tissue specimens and cervical mucus at different stages of the menstrual cycle.

Methods

Samples of tissue and mucus from the uterine cervix were obtained from specimens from 20 premenopausal patients undergoing hysterectomy. Eight uteri were removed during the follicular phase (day 1 - 8), five in the periovulatory phase (day 12 - 16), and seven in the secretory phase (day 17 - 28). Paraffin-embedded slides were stained with a VEGF antibody covering the splicing variants 165, 189 and 121. Cervical mucus was examined for VEGF 165 with an enzyme-linked immunoassay. Data were analyzed with the Wilcoxon two-sample test.

Results

Uteri in the early proliferative phase showed distinct VEGF staining of the basal epithelium of the cervix. During the late follicular and periovulatory phases, staining in the apical epithelium and cervical stroma increased and the VEGF concentration in the cervical mucus was highest (97 pg/mg total protein). After ovulation VEGF in the epithelium fell sharply, to then reappear in the mid and late secretory phase.

Conclusion

VEGF increases in the cervical stroma around the time of ovulation and may play a role in the liquefaction of the cervical mucus and tissue edema. These changes are likely involved with the opening of the cervix at near the time of ovulation. Literatur - 1 Bokström H, Brännström M, Alexandersson M, Norström A. Leukocyte subpopulations in the human uterine cervical stroma at early and term pregnancy. Hum Reprod. 1997; 12 586-590 - 2 Brown L F, Detmar M, Tognazzi K, Abu-Jawdeh G, Iruela-Arispe M L. Uterine smooth muscle cells express functional receptors (flt-1 and KDR) for vascular permeability factor/vascular endothelial growth factor. Lab Invest. 1997; 76 245-255 - 3 Charnock-Jones S, Sharkey A M, Rajput-Williams J, Burch D, Schofield J P, Fountain S A, Boocock C A, Smith S K. Identification and localization of alternately spliced mRNAs for vascular endothelial growth factor in human uterus and estrogen regulation in endometrial carcinoma cell lines. 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Leukocytes infiltrate the myometrium during human parturition: further evidence that labour is an inflammatory process. Hum Reprod. 1999; 14 229-236 - 27 Wang W, Merrill M J, Borchardt R T. Vascular endothelial growth factor affects permeability of brain microvessel endothelial cells in vitro. Am J Physiol. 1996; 271 1973-1980 Dr. Prof. Dr. Birgit Kemp W. Rath Frauenklinik des Universitätsklinikums Aachen Pauwelsstr. 30 52057 Aachen Email: [email protected]

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