Pathogenetic Mechanisms of Formation of External Genital Endometriosis and Its Relapses in Patients of Reproductive Age

Abstract

Purpose: To reveal peculiarities of angiogenesis from the pint of autoparacrine cellular regulation and to amplify the mechanisms of formation of external genital endometriosis.Materials and Methods: 352 patients were divided to 3 clinical groups: I - 148 patients with I-II stages of EHE, II group -184 patients with III-IV stage, 24 ones among them were with relapse. The III control group was presented by 20 patients without endometriosis. We used clinical methods, clinicolaboratory methods, genetic, morphological, biochemical.Results: On the systemic level the disorders of auto–para– and intracrine cellular regulation of angiogenesis with high production of EGF, bFGF, IGF-1, VEGF, solutable receptor of EGF and sFlt and low production of leptin. On the local level we found severe decrease of apoptosis, which was devoted to IL-8, NO, FSH and the simultaneous reinforcement by IL-8 of angiogenesis activity in endometrioid heterotopies and also the capillary vasodilatation with participation of NO. The increase of VEGF production on systemic level and high content of solutable receptor of VEGF, NO and NO- syntaze on the local level (the peritoneal fluid) are typical for relapsing of EGE.Summary: The switсhing of disorder of regulatory control of the cellular metabolism from one growth factors to another is happened in different stages of external genital endometriosis formation.

Keywords

• external genital endometriosis
• angiogenesis
• apoptosis
• proliferation
• regulation