Angiogene Aktivität der Douglasflüssigkeit von Patientinnen mit Endometriose nach oraler Applikation von 5-Aminolävulinsäure

Eduard Malik, C. Berg, A. Meyhöfer-Malik, K. Diedrich
In: Geburtshilfe und Frauenheilkunde · 1999 · vol. 59(12) , pp. 622–625 · doi:10.1055/s-1999-15639 · W2015068274
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

Peritoneal fluid from endometriosis patients, especially fluorescent fluid after 5-ALA administration, exhibited significantly higher angiogenic activity than fluid from control patients.

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The study evaluated whether angiogenic activity differs between fluorescent and non-fluorescent peritoneal (Douglas) fluid in women with endometriosis, using 5-aminolevulinic acid (ALA) administered orally before laparoscopy. Peritoneal fluid from 11 endometriosis patients who received ALA (and from 7 control patients with normal peritoneal findings who did not receive ALA) was applied to sterile filter disks and implanted on the chorioallantoic membrane of fertilized chicken eggs to assess angiogenesis after incubation. Peritoneal fluid from endometriosis patients showed higher angiogenic activity than control fluid, and within the endometriosis group fluorescent fluid exhibited greater angiogenic activity than non-fluorescent fluid, with significant differences reported (p < 0.01). The paper’s main limitation is the relatively small sample size. This paper is centrally about endometriosis — it tests whether ALA-induced fluorescence of peritoneal fluid reflects endometriosis activity via angiogenic assays.

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Abstract

Objective: We evaluated the angiogenic activity of fluorescent and non-fluorescent peritoneal fluid in patients with endometriosis. Methods: Eleven women with endometriosis received 5-amino-levulinic acid (30 mg/kg body weight) orally 10-14 hours before laparoscopy. At laparoscopy the peritoneum was evaluated in white light and fluorescent light and peritoneal fluid was obtained. The control group consisted of seven patients with normal peritoneal findings who did not receive 5-aminolevulinic acid. Sterile filter disks were impregnated with peritoneal fluid and implanted on the chorioallantoic membrane of fertilized chicken eggs (n=105). Angiogenesis was evaluated after 4 days of incubation. Results: Strong fluorescence of the peritoneal fluid was seen in six of 11 patients with endometriosis. Peritoneal fluid from patients with endometriosis had significantly more angiogenic activity than that from patients with normal peritoneal findings (p <0.01). In patients with endometriosis, fluorescent peritoneal fluid had more angiogenic activity than nonfluorescent fluid (p <0.01). Conclusions: The fluorescence of the peritoneal fluid may be a marker for the activity of endometriosis.
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Material

und Methodik: Nach oraler Applikation von 30 mg ALA/kg Körpergewicht wurde fluoreszierende und nicht fluoreszierende Douglasflüssigkeit von 11 Endometriosepatientinnen und 7 Patientinnen mit einem unauffälligen inneren Genitale (Kontrollgruppe) auf die Chorioallantoismembran des befruchteten Hühnereies implantiert. Ergebnisse: Fluoreszierende Douglasflüssigkeit zeigte höhere Angiogenesegrade als nicht fluoreszierende Douglasflüssigkeit. Die nicht fluoreszierende Douglasflüssigkeit von Endometriosepatientinnen unterschied sich in ihrer angiogenen Potenz nicht von Douglasflüssigkeit von Patientinnen aus der Kontrollgruppe. Schlußfolgerung: Die Fluoreszenz nach ALA-Applikation könnte eine erhöhte Aktivität der Endometriose signalisieren.

Abstract

Objective: We evaluated the angiogenic activity of fluorescent and non-fluorescent peritoneal fluid in patients with endometriosis.

Methods

Eleven women with endometriosis received 5-amino-levulinicacid (30 mg/kg bodyweight) orally 10-14 hours before laparoscopy. At laparoscopy the peritoneum was evaluated in white light and fluorescent light and peritoneal fluid was obtained. The control group consisted of seven patients with normal peritoneal findings who did not receive 5-aminolevulinic acid. Sterile filter disks were impregnated with peritoneal fluid and implanted on the chorioallantoic membrane offertilized chicken eggs (n=105). Angiogenesis was evaluated after 4 days of incubation.

Results

Strong fluorescence of the peritoneal fluid was seen in six of 11 patients with endometriosis. Peritoneal fluid from patients with endometriosis had significantly more angiogenic activity than that from patients with normal peritoneal findings (p <0.01). In patients with endometriosis, fluorescent peritoneal fluid had more angiogenic activity than nonfluorescent fluid (p <0.01).

Conclusions

The fluorescence of the peritoneal fluid may be a marker for the activity of endometriosis.

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