Human Reproduction Update Advance Access originally published online on March 8, 2007
Human Reproduction Update 2007 13(4):331-342; doi:10.1093/humupd/dmm006
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In vitro and in vivo approaches to study angiogenesis in the pathophysiology and therapy of endometriosis
Institute for Clinical and Experimental Surgery, University of Saarland, D-66421 Homburg/Saar, Germany
1 Correspondence address: Institute for Clinical and Experimental Surgery, University of Saarland, D-66421 Homburg/Saar, Germany. Tel: +49 6841 162 6554; Fax: +49 6841 162 6553; E-mail: matthias.laschke{at}uniklinik-saarland.de
Endometriosis represents one of the most common gynaecological disorders. According to the implantation theory, angiogenesis is a major prerequisite for the initiation and progression of the disease. Thus, during the last decade, many studies have focused on the mechanisms regulating angiogenesis in endometriotic lesions. For this purpose, sophisticated in vitro and in vivo approaches have been established, which are highlighted in this review. Enzyme-linked immunosorbent assays demonstrate the imbalance of pro- and anti-angiogenic growth factors in isolated peritoneal fluid from endometriosis patients. Histological, immunohistochemical and gene expression analyses of endometriotic tissue provide detailed information on the angio-architecture of endometriotic lesions and the different growth factor expression by various cell populations. Moreover, cell culture systems are useful tools for the identification of hormonal and immunological factors involved in the angiogenic process. Finally, sophisticated in vivo models, such as rodent models of peritoneal endometriosis as well as the chorioallantoic membrane assay and the dorsal skinfold chamber, allow for the detailed analysis of blood vessel development in ectopic endometrium and the efficacy of angiogenesis inhibitors. The findings resulting from all these approaches will help to provide better insights into the pathophysiology of endometriosis and to establish new anti-angiogenic treatment strategies for the future.
Key words: angiogenesis / dorsal skinfold chamber / endometriosis / peritoneal fluid / rodent models
Received on September 11, 2006; revised January 9, 2007; accepted on January 16, 2007
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