Die Bedeutung der Angiogenese für die Pathogenese der Endometriose
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Angiogenesis in ectopic endometrium is crucial for endometriosis pathogenesis and lesion activity, as shown by VEGF and MMP mRNA expression correlating with vascularity in a CAM assay.
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The paper discusses how implantation of ectopic endometrial tissue is a key step in endometriosis pathogenesis and argues that angiogenesis is both a prerequisite for implantation and a parameter reflecting lesion activity. Using a chorioallantoic membrane (CAM) assay model with ectopic endometrial fragments, the authors analyzed time-dependent mRNA expression of VEGF and matrix metalloproteinases MMP1 and MMP2 and correlated these molecular changes with angiogenesis assessed by a vessel density index. They report an increase in angiogenic factors and an increase in angiogenic reaction over time, implying a link between angiogenic signaling and implanting aggressiveness. The study’s main limitation is that these findings are derived from an experimental CAM model rather than directly from human lesions in vivo. This paper is centrally about endometriosis — it focuses on how angiogenesis (VEGF/MMP-related activity) supports implantation and lesion activity in the pathogenesis of endometriosis.
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Abstract
The pathogenesis of endometriosis is dependent on implantation. Therefore, angiogenesis of the ectopic endometrium is discussed as a crucial step in the development of an endometriotic lesion. It is not only the main condition for implantation, but also a parameter for the clinical activity of endometriosis. Pigmented and non-pigmented endometriotic lesions differ according to their clinical activity and angiogenic potential. Using a model system of endometriosis, the chorioallantoic membrane assay, mRNA expression of VEGF and matrix metalloproteinases 1 and 2 was analysed. As the most representative angiogenic factors, they were correlated to the angiogenic reaction on the CAM by the vessel index. We assume that angiogenic activity of ectopic endometrium is a condition sine qua non for the pathogenesis of endometriosis, but is regulated by different other factors.
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DOI: 10.1055/s-2003-42278
© Georg Thieme Verlag Stuttgart · New York
Die Bedeutung der Angiogenese für die Pathogenese der Endometriose
The Importance of Angiogenesis for the Pathogenesis of EndometriosisPublication History
Publication Date:
23 September 2003 (online)
Zusammenfassung
Für die Pathogenese der Endometriose ist der Vorgang der Implantation der Schlüsselpunkt,
der darüber entscheidet, ob ektope Endometriumzellen zum Krankheitsbild der Endometriose
führen oder nicht. Voraussetzung für die Implantation ist die Expression angiogenetisch
relevanter Faktoren, die die Angiogenese induzieren. Dabei ist für die Implantationsaggressivität
die angiogenetische Aktivität der Läsionen entscheidend. Die Angiogenese ist somit
nicht nur Bedingung, sondern auch ein wichtiger Parameter für die Aktivität der
Erkrankung.
Bisherige Studien am Chorioallantoismembran (CAM) Modell, einem dynamischen Modell
der Endometriose, untersuchten den Implantationsprozess ektoper Endometriumfragmente.
Analysiert wurde im Zeitverlauf die mRNA Expression des vaskulären endothelialen
Wachstumsfaktors (VEGF) sowie der Matrix-Metalloproteinasen (MMP)1 und -2. Anhand
der zeitgleichen Bestimmung des Gefäßdichteindexes der CAM konnten diese Ergebnisse
mit der Angiogenese korreliert werden. Es konnte ein Anstieg der angiogenetischen
Faktoren sowie ein Anstieg der Angiogenese gemessen werden.
Abstract
The pathogenesis of endometriosis is dependent on implantation. Therefore, angiogenesis
of the ectopic endometrium is discussed as a crucial step in the development of an
endometriotic lesion. It is not only the main condition for implantation, but also
a parameter for the clinical activity of endometriosis. Pigmented and non-pigmented
endometriotic lesions differ according to their clinical activity and angiogenic
potential.
Using a model system of endometriosis, the chorioallantoic membrane assay, mRNA
expression of VEGF and matrix metalloproteinases 1 and 2 was analysed. As the most
representative angiogenic factors, they were correlated to the angiogenic reaction
on the CAM by the vesselindex.
We assume that angiogenic activity of ectopic endometrium is a conditio sine qua
non for the pathogenesis of endometriosis, but is regulated by different other factors.
Schlüsselwörter
Endometriose - Angiogenese - VEGF - Matrix-Metalloproteinase (MMP) - Aktivität - Implantation
Key words
Endometriosis - angiogenesis - VEGF - MMP - activity - implantation
Literatur
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Dr. med. D. M. Gescher
Universitätsklinikum der RWTH Aachen · Frauenklinik für Gynäkologie und Geburtshilfe
Pauwelstraße 30
520741 Aachen
Phone: 02 41/8 08 84 01
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Cited by (11)
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- Serum salusins levels are increased and correlated positively with cyst size in ovarian endometrioma 2015
- Rolle der Angiogenese und ihrer Inhibitoren in der Gynäkologie 2012
- Vascular endothelial growth factor expression up-regulated by endometrial ischemia in secretory phase plays an important role in endometriosis 2011
- Novel Therapies Targeting Endometriosis 2011
- The remedial effect of soluble interleukin-1 receptor type II on endometriosis in the nude mouse model 2010
- Association between genetic polymorphisms in fibroblast growth factor (FGF)1 and FGF2 and risk of endometriosis and adenomyosis in Chinese women 2010
- Pathogenèse de l'endométriose 2007
- Proliferative Activity of Microvessels and Angiogenesis in Eutopic Endometrium in Patients with Peritoneal Endometriosis 2005
- FGF-1 and S100A13 possibly contribute to angiogenesis in endometriosis 2005
- Combined inhibition of vascular endothelial growth factor (VEGF), fibroblast growth factor and platelet-derived growth factor, but not inhibition of VEGF alone, effectively suppresses angiogenesis and vessel maturation in endometriotic lesions 2005
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