Paracrine changes in the peritoneal environment of women with endometriosis
Paracrine changes in the peritoneal environment of women with endometriosis
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DOI：
10.1093/humupd/4.5.719
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发表时间：
1998-09-01
影响因子：
13.3
通讯作者：
Diedrich, K
中科院分区：
文献类型：
--
作者：
Küpker, W;Schultze-Mosgau, A;Diedrich, K
在过去的十年中，在子宫内膜异位症女性的腹腔液中检测到了巨噬细胞衍生的物质，如前列腺素、细胞因子、生长因子和血管生成因子。特别地，生长促进因子和血管生成因子被认为实质上参与子宫内膜异位症的发病机制。本研究利用最近在子宫内膜异位症女性腹腔液中检测到的血管内皮生长因子（VEGF）、转化生长因子β（TGF-β）和细胞间粘附分子1（ICAM-1）等物质，评估其在子宫内膜异位症不同阶段的浓度以及促性腺激素释放激素激动剂（GnRHa）治疗后腹膜旁分泌活性的变化。子宫内膜异位症患者在接受 4 个月的 GnRHa 治疗之前和之后进行腹腔镜检查时获得腹膜液。血管内皮生长因子； TGF-P 和 ICAM-1 可以在所有患有不同阶段的活动性子宫内膜异位症的女性中检测到。 GnRHa 治疗后，所有患者的 VEGF (194 +/- 77 pg/ml)、TGF-β (902 +/- 273 pg/ml) 和 ICAM-1 (157 +/- 52 ng/ml) 平均浓度均显着降低。与轻度子宫内膜异位症患者（rAFS I 期和 II 期）相比，III 期和 IV 期子宫内膜异位症患者（根据 rAFS 评分）在治疗前的 VEGF 和 TGF-β 浓度要高得多。最显着的浓度下降是 TGF-β，从治疗前的 902 pg/ml 降至治疗后的 273 pg/ml。这些结果表明旁分泌活性在子宫内膜异位症的形成和维持中发挥着重要作用。事实上，GnRHa 治疗可能通过雌激素水平低下降低腹膜腔中的旁分泌活性，并提供治疗成功的证据。
During the past decade, macrophage-derived substances such as prostanoids, cytokines, growth factors and angiogenic factors have been detected in the peritoneal fluid of women with endometriosis. In particular, growth-promoting and angiogenic factors are considered to be substantially involved in the pathogenesis of endometriosis. In this study, vascular endothelial growth factor (VEGF), transforming growth factor beta (TGF-beta) and intercellular adhesion molecule 1 (ICAM-1), substances recently detected in the peritoneal fluid of women with endometriosis, were assessed with regard to their concentrations in different stages of endometriosis and changes of the peritoneal paracrine activity after medical treatment with a gonadotrophin releasing hormone agonist (GnRHa). Peritoneal fluid was obtained from patients with endometriosis during laparoscopy before and after a 4-month treatment with a GnRHa. VEGF; TGF-P and ICAM-1 could be detected in all women presenting with various stages of active endometriosis. After GnRHa therapy, all patients showed significant decreases in mean concentrations of VEGF (194 +/- 77 pg/ml), TGF-beta (902 +/- 273 pg/ml) and ICAM-1 (157 +/- 52 ng/ml). Patients with stage III and IV endometriosis (according to the rAFS score) had much higher concentrations of VEGF and TGF-beta before treatment compared with those patients with mild endometriosis (rAFS stages I and II). The most striking decrease in concentration was for TGF-beta, from 902 pg/ml before to 273 pg/ml after therapy, These results indicate an important role for paracrine activity in the establishment and maintenance of endometriosis, Indeed, treatment with a GnRHa may reduce paracrine activity in the peritoneal cavity via hypo-oestrogenism and provide proof of successful therapy.