Increased Pregnancy-Associated Plasma Protein-A (PAPP-A) Concentrations in Peritoneal Fluid of Women with Endometriosis
Version of Record online: 21 FEB 2003
American Journal of Reproductive Immunology
Volume 49, Issue 2, pages 70–74, February 2003
How to Cite
Arici, A., Matalliotakis, I., Goumenou, A., Koumantakis, G., Fragouli, Y. and Mahutte, N. G. (2003), Increased Pregnancy-Associated Plasma Protein-A (PAPP-A) Concentrations in Peritoneal Fluid of Women with Endometriosis. American Journal of Reproductive Immunology, 49: 70–74. doi: 10.1034/j.1600-0897.2003.01164.x
- Issue online: 21 FEB 2003
- Version of Record online: 21 FEB 2003
- Submitted March 13, 2002; revised May 8, 2002; accepted June 25, 2002.
- peritoneal fluid;
- placental protein-14;
- pregnancy-associated plasma protein-A
PROBLEM: Pregnancy-associated plasma protein-A (PAPP-A) belongs to a group of glycoproteins isolated from extracts of human placenta. Healthy ovarian and uterine tissues are also known to express PAPP-A. We hypothesized that PAPP-A levels might also be elevated in the peritoneal fluid (PF) of women with endometriosis, and examined variations in PF PAPP-A during the menstrual cycle and with the severity of the disease.
METHOD OF STUDY: PF PAPP-A were measured in 60 women with endometriosis and 38 women without endometriosis using a high-sensitivity immunofluorometric assay.
RESULTS: We found that the mean level of PAPP-A was higher in PF from patients with endometriosis than controls (p = 0.003). Furthermore, significant correlation was found between the stages of endometriosis and the levels of PAPP-A in these patients (r = 0.39, p = 0.009). The concentrations of PAPP-A in PF were significantly higher in the secretory phase than the proliferative phase of the menstrual cycle in both women with and without endometriosis (p = 0.009 and P = 0.002, respectively). Finally, among the controls, women undergoing tubal ligation had significantly lower mean PF levels of PAPP-A than women with infertility or pelvic pain (p = 0.001).
CONCLUSION: We conclude that PF levels of PAPP-A vary during the menstrual cycle, and are highest in the secretory phase. We also find that PF PAPP-A levels are significantly increased in women with endometriosis, and that the degree of elevation corresponds to the extent of disease.