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

ObjectiveTo investigate the involvement of 8-iso-PGF2α and 25-hydroxycholesterol (25-OH-Chol) in the pathophysiology of endometriosis.DesignObservational case-control study using enzyme immunoassay and high-performance liquid chromatography (HPLC).SettingPostgraduate Institute of Medical Education and Research.Patient(s)Forty-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-PGF2α 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-PGF2α 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-PGF2α and oxysterols (the known promoters of steroidogenesis) might be the culprits in this disease.