Human Reproduction, Vol. 18, No. 7, 1516-1522,
July 2003
© 2003 European Society of Human Reproduction and Embryology
Expression of several components of the plasminogen activator and matrix metalloproteinase systems in endometriosis
1 Maternal Hospital, 2 Research Center, 3 Anatomopathology, 4 Cardiology and 5 Clinical Pathology Departments, Hospital Universitario La Fe, and 6 Gynecology Service, Hospital Arnau de Vilanova, Valencia, Spain
7 To whom correspondence should be addressed at: Hospital Universitario ‘La Fe’, Centro de Investigación. Avda. Campanar 21, 46009 Valencia, Spain. e-mail: estelles_amp{at}gva.es
BACKGROUND: Endometriosis is considered a benign disease that has the ability to invade normal tissue. As in neoplastic growth, local extracellular proteolysis may take place. The aim of this study is to analyse several components of the plasminogen activator (PA) pathway and the matrix metalloproteinase (MMP) system in endometriotic tissue, endometrium and peritoneal fluid from women with and without endometriosis (controls). METHODS AND RESULTS: Thirty-nine women with endometriosis and 35 controls were studied. In eutopic endometrium of women with endometriosis, the antigenic levels of urokinase-type PA (uPA) and MMP-3 were elevated when compared with endometrium from controls. Ovarian endometriotic tissues had higher antigenic levels of PA inhibitor type 1 (PAI-1) and tissue inhibitor of metalloproteinases type 1 (TIMP-1) than endometrium. The peritoneal fluid from women with endometriosis showed a significant increase in uPA levels compared with controls. CONCLUSIONS: The increase in antigenic levels of uPA and MMP-3 in endometrium of women with endometriosis might contribute to the invasive potential of endometrial cells. Once the ovarian endometriotic cyst is developed, an increase in PAI-1 and TIMP-1 is detected and significant proteolytic activity is no longer observed. This increase in inhibitors and decrease in proteolytic activity could explain the frequent clinical finding of isolated endometriotic cyst without invasion of the surrounding ovarian tissue.
Key words: endometriosis/MMP-3/PAIs/plasminogen activators/TIMP-1
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