Endometriosis May Be Promoted by Midkine: Possible Involvement of Ovarian Follicles

Endometriosis is an enigmatic disease, the etiology of which is poorly understood. The lesion of endometriosis is preferentially located in the peritoneum around the ovary. We therefore speculated that some local factor derived from the ovary is involved in the development of endometriosis. Relatively high concentrations (higher than 200 ng/ml) of midkine are detected in follicular fluids in the ovary, implying its roles in the follicular growth. In contrast, concentrations of midkine in peritoneal fluid are around 1 ng/ml. Midkine concentrations in peritoneal fluid increase after ovulation, suggesting that midkine in follicular fluid erupting at ovulation contribute to the concentrations in peritoneal fluid. Interestingly, midkine (higher than 100 ng/ml) stimulates the proliferation of endometriotic stromal cells. Therefore, it is plausible that endometriotic lesions are stimulated to grow by directly exposed to midkine in follicular fluid at the time of ovulation. In addition, midkine concentrations in peritoneal fluid are higher in women with advanced endometriosis compared to those with no or minimal endometriosis, further suggesting the involvement of MK in endometriosis. Access this chapter Tax calculation will be finalised at checkout Purchases are for personal use only Similar content being viewed by others

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