GnRH-a on Angiogenesis of Endometriosis
Condition: Angiogenesis; Endometriosis
MeSH terms: Endometriosis
Study type: Interventional

Summary: 
      Purpose: Neo-angiogenesis is necessary for adhesion and invasiveness of endometriotic lesions
      in women affected by endometriosis. VEGF is one of the major components of angiogenesis and
      is part of the major pathway TF-PAR-2-VEGF that leads to neo-angiogenesis. SP1 is a
      transcriptional factor that has lately been studied for its crucial role in angiogenesis, via
      a distinct pathway. We hypothesize that by blocking angiogenetic pathways we can repress
      endometriotic lesions. GnRH-agonists are routinely used, especially pre-operatively, in
      endometriosis. It would be interesting to clarify which angiogenetic pathways are affected
      and pave the way for further research over anti-angiogenetic effects on endometriosis.

      Methods: We used qRT-PCR to study mRNA expression levels of TF, PAR-2, VEGF and SP1 in
      endometriotic tissues of women who underwent surgery for endometriosis and received GnRH-a
      [leuprolide acetate] preoperatively.
    

Detailed description: 
      The subjects in this study were women of reproductive age. From September 2015 to December
      2022, sixty women with known endometriosis [stage 2 and 3], were recruited. Their mean age
      was 38 years. They were nulliparous and had a mean BMI of 27 kg/m2. The ovarian endometrioma,
      present in all the participants, was diagnosed by ultrasonography and/or magnetic resonance
      imaging.

      This was a prospective randomized follow up study with analysis of ovarian samples derived
      from GnRH agonists-treated and non-treated women before surgery. The randomization was
      performed by accessing a central internet-based randomization program. The random allocation
      sequence and the assignment of the participants to interventions were made by 2 of the
      authors [A.K. and S.K].

      After enrollment, patients were divided into 2 groups . During laparoscopy, biopsy specimens
      of the ovarian endometrioma were collected. The staging of endometriosis was based on the
      rASRM classification system. In group B, surgery was performed during the proliferative phase
      of the menstrual cycle. All biopsy specimens were collected in accordance with the guidelines
      of the Declaration of Helsinki and with the approval of the ethical committee of the General
      University Hospital of Patras. Informed consent was obtained from all women.
    

Intervention name(s): Leuprolide Acetate
Intervention type(s): Drug
Intervention description(s): Leuprolide acetate was administered 3 months before laparoscopy in women of group A.
Intervention MeSH terms: Leuprolide
Allocation: Randomized
Intervention model: Parallel Assignment
Intervention model description: This was a prospective randomized follow up study with analysis of ovarian samples derived from GnRH agonists-treated and non-treated women before surgery. The randomization was performed by accessing a central internet-based randomization program. The random allocation sequence and the assignment of the participants to interventions were made by 2 of the authors [A.K. and S.K].
Masking: Single (Participant)
Primary purpose: Basic Science
Keywords: Endometriosis; Angiogenesis; GnRH-a; VEGF; SP1