Role of 8-iso-prostaglandin F2α and 25-hydroxycholesterol in the pathophysiology of endometriosis

Objective: To investigate the involvement of 8-iso-PGF(2 alpha) and 25-hydroxycholesterol (25-OH-Chol) in the pathophysiology of endometriosis. Design: Observational case-control study using enzyme immunoassay and high-performance liquid chromatography (HPLC). Setting: Postgraduate Institute of Medical Education and Research. Patient(s): Fort y-five women undergoing laparoscopy (n = 25), laparotomy (n = 19), or tubal ligation (n = 1). Intervention(s): Venipuncture and laparoscopic peritoneal fluid (PF) collection. Main Outcome Measure(s): The levels of 8-iso-PGF(2 alpha) were determined both in urine and PF of all the patients using enzyme immunoassay. The levels of 25-OH-Chol were determined by using reversed phase HPLC both in the plasma and PF samples. Oxidative damage to DNA was assessed by agarose gel electrophoresis. Result(s): Significantly increased levels of 8-iso-PGF(2 alpha) were observed both in urine and PF of women with endometriosis compared with control women. Similarly, higher levels of 25-OH-Chol were observed both in plasma and PF of patients compared with controls and the difference was statistically significant. A clear-cut tailing pattern was observed in DNA of patients with endometriosis, indicating significant DNA damage. Conclusion(s): Our observations implicate oxidative stress in the pathophysiology of endometriosis. For the first time, we demonstrate that 8-iso-PGF(2 alpha) and oxysterols (the known promoters of steroidogenesis) might be the culprits in this disease. (Fertil Steril (R) 2010;94:63-70. (C) 2010 by American Society for Reproductive Medicine.)