Women With Endometriosis Have Increased Levels of Placental Growth Factor in the Peritoneal Fluid Compared With Women With Cystadenomas

Nobuhiro Suzumori, Mayumi Sugiura‐Ogasawara, Kinue Katano, Kaoru Suzumori
In: Obstetrical & Gynecological Survey · 2004 · vol. 59(6) , pp. 438–439 · doi:10.1097/00006254-200406000-00019 · W2114723946
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This study found significantly higher concentrations of placental growth factor (PlGF) in the peritoneal fluid of women with endometriosis compared to those with cystadenomas, with levels varying by endometriosis stage and menstrual cycle phase.

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This study measured placental growth factor (PlGF) concentrations in the peritoneal fluid of 35 women with endometriosis and 24 control patients with ovarian cystadenomas. The results demonstrated significantly higher median PlGF levels in the endometriosis group compared to controls, with concentrations varying according to disease stage and being particularly elevated in those with red peritoneal lesions. Additionally, PlGF levels were higher during the secretory phase of the menstrual cycle than the proliferative phase in both groups, indicating sensitivity to ovarian steroid changes. This paper is centrally about endometriosis — specifically investigating the role of angiogenic factors like PlGF in its pathophysiology and lesion development.

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Abstract

Placental growth factor (PlGF) is a secreted glycoprotein that is expressed in endothelial and epithelial cells as well as in some tumors. The investigators thought that the concentration of PlGF, which is an angiogenic actor, might be elevated in the peritoneal fluid of women with endometriosis. PlGF concentrations were measured with an enzyme-linked immunosorbent assay in 35 women with endometriosis and 24 control women with ovarian cystadenoma who were scheduled for surgery. All participants had regular menstrual cycles. The 2 groups were matched for parity. Peritoneal fluid from women with endometriosis contained significantly higher concentrations of PlGF than that from control women. Median levels were 189 and 88 pg/mL, respectively. Levels varied significantly with the stage of endometriosis (Fig. 1) and were significantly higher in the presence of peritoneal implants classified as red lesions. In both groups, concentrations of PlGF were significantly higher in the secretory phase of the menstrual cycle than in the proliferative phase. These findings suggest that the production of PlGF is sensitive to cyclical changes in ovarian steroid concentrations and could contribute to an important degree to the development of endometriosis, particularly in patients having red lesions. It seems possible that PlGF in peritoneal fluid promotes neovascularization.Fig. 1: Concentrations of PlGF in peritoneal fluid as determined by enzyme linked immunosorbent assay. The boxes delimit values falling between the 25th and the 75th percentiles and the horizontal lines refer to the median scores. (A) The difference between the control (cystadenoma) group (n = 24) and the endometriosis group (n = 35) is significant (P < 0.001). In the endometriosis patients, elevated PlGF levels (P < 0.001) are apparent in the stage II group as compared with the other stage groups. (B) Significant differences in PlGF levels with stage of menstrual cycle are evident in both the control (cystadenoma) group (P < 0.05) and the endometriosis group (P < 0.001). P = proliferative phase; S = secretory phase. Reproduced with permission. Hum Reprod 2003;18:2595–2598. Copyright © 2003, Oxford University Press. All rights reserved.
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Women With Endometriosis Have Increased Levels of Placental Growth Factor in the Peritoneal Fluid Compared With Women With Cystadenomas - Nobuhiro Suzumori - Mayumi Sugiura-Ogasawara - Kinue Katano - Kaoru Suzumori Placental growth factor (PlGF) is a secreted glycoprotein that is expressed in endothelial and epithelial cells as well as in some tumors. The investigators thought that the concentration of PlGF, which is an angiogenic actor, might be elevated in the peritoneal fluid of women with endometriosis. PlGF concentrations were measured with an enzyme-linked immunosorbent assay in 35 women with endometriosis and 24 control women with ovarian cystadenoma who were scheduled for surgery. All participants had regular menstrual cycles. The 2 groups were matched for parity. Peritoneal fluid from women with endometriosis contained significantly higher concentrations of PlGF than that from control women. Median levels were 189 and 88 pg/mL, respectively. Levels varied significantly with the stage of endometriosis (Fig. 1) and were significantly higher in the presence of peritoneal implants classified as red lesions. In both groups, concentrations of PlGF were significantly higher in the secretory phase of the menstrual cycle than in the proliferative phase. These findings suggest that the production of PlGF is sensitive to cyclical changes in ovarian steroid concentrations and could contribute to an important degree to the development of endometriosis, particularly in patients having red lesions. It seems possible that PlGF in peritoneal fluid promotes neovascularization.

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