The vascular endothelial growth factor (VEGF) +405G>C 5′-untranslated region polymorphism and increased risk of endometriosis in South Indian women:: a case control study

BACKGROUND: Vascular endothelial growth factor (VEGF), a major mediator of angiogenesis and vascular permeability, is known to play a key role in the pathophysiology of endometriosis. METHODS AND RESULTS: The single nucleotide polymorphisms, -460C > T and +405G > C, in the 5'-untranslated region of the VEGF gene were tested for association in a case-control study of 215 affected women and 210 women with no evidence of disease. All the women were of South Indian origin and ascertained from the same infertility clinic. The genotype and allele frequencies of the -460C > T polymorphism did not differ significantly between cases and controls. In contrast, the genotype (P = 0.002) and allele (P = 0.001) frequencies of the +405G > C polymorphism showed a significant difference between cases and controls. The +405 GG genotype was found more often in patients with an endometrioma > 3 cm compared to controls. The frequency of the -460T/+ 405C haplotype (P = 0.016) was significantly lower in affected women compared to controls. CONCLUSIONS: The -460T/+405C haplotype in the VEGF gene, which is associated with lower promoter activity, was significantly less common in women with endometriosis than in controls. These data suggest that the +4056 allele may influence the likelihood of a woman developing the disease.