Vascular endothelial growth factor pathway in endometriosis: genetic variants and plasma biomarkers

Our study showed that, in Caucasian women, genetic variants in the PLGF rs2268613 gene influences PLGF plasma levels. Plasma levels of VEGF were elevated in endometriosis patients compared with controls.

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Authors

Alexandra Vodolazkaia, M.D., Ph.D., Betul Tuba Yesilyurt, Ph.D., Cleophas Mutinda Kyama, Ph.D., Attila Bokor, M.D., Ph.D., Dominique Schols, Ph.D., Dana Huskens, Ph.D., Christel Meuleman, M.D., Ph.D., Karen Peeraer, M.D., Carla Tomassetti, M.D., Xavier Bossuyt, M.D., Ph.D., Diether Lambrechts, Ph.D., Thomas D’Hooghe, M.D., Ph.D., Amelie Fassbender, Ph.D.

Volume 105, Issue 4, Pages 988-996

Abstract

Objective:

To study single nucleotide polymorphisms (SNPs) involved in angiogenesis (VEGF, PLGF, VEGFR1, VEGFR2, HIF-1α) and plasma levels of the corresponding proteins (VEGF, PLGF, sVEGFR1, sVEGFR2) in women with and without endometriosis.

Design:

Allele frequencies of vascular endothelial growth factor (VEGF) pathway SNPs and plasma levels of the corresponding proteins were investigated in patients with endometriosis and in controls.

Setting:

University hospital.

Patient(s):

Samples of DNA from 1,931 Caucasian patients were included (1,109 patients with endometriosis and 822 controls). An additional study group included 973 DNA samples from volunteers, self-reported to be healthy without laparoscopic evaluation.

Intervention(s):

Women who underwent a laparoscopy for subfertility and/or pain and healthy volunteers without laparoscopic evaluation.

Main Outcome Measure(s):

Functional SNPs of the VEGF, VEGFR1, VEGFR2, HIF-1α genes and Hap Map tagging SNPs of the PLGF gene were genotyped by using iPLEX technology on a Sequenom MassArray and TaqMan SNP Genotyping Assay. The VEGF levels were determined in ethylenediaminetetraacetic acid plasma samples by using Bio-Plex Protein Array System. PLGF, sVEGFR1, and sVEGFR2 levels were measured in ethylenediaminetetraacetic acid plasma samples by using ELISA Quantikine kits.

Result(s):

A significant association was found between the rs2268613 polymorphism in the PLGF gene and PLGF plasma levels. In all study subjects, women with the AA variant of the rs2268613 PLGF gene had significantly lower PLGF plasma levels (median [interquartile range] 9.36 [8.19–10.43] pg/mL) than those with the AG variant (12.1 [11.81–20.84] pg/mL; Pa=.0085, Pb=.04), both before and after multiple testing. Plasma levels of VEGF were elevated in endometriosis patients (especially in minimal–mild endometriosis during the menstrual cycle phase) compared with laparoscopic controls but had a moderate diagnostic performance (area under the curve, 0.73) in this discovery dataset. At a cut-off plasma level of VEGF >3.88 pg/mL, minimal–mild stages of endometriosis were diagnosed with a sensitivity of 74% and a specificity of 80% during the menstrual phase of cycle. The associations between the presence of endometriosis and SNPs in PLGF (rs2268614), HIF-1α (rs11549465), and VEGFR1 (rs9582036) genes lost statistical significance after multiple testing.

Conclusion(s):

Genetic variants in the PLGF rs2268613 gene may influence plasma levels of the corresponding protein. Plasma levels of VEGF were elevated in endometriosis patients compared with controls. The associations between the presence of endometriosis and SNPs in PLGF (rs2268614), HIF-1α (rs11549465), and VEGFR1 (rs9582036) genes lost statistical significance after multiple testing.

Read the full text at: http://www.fertstert.org/article/S0015-0282(15)02185-8/fulltext

Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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