Proteomic analysis of serum yields six candidate proteins that are differentially regulated in a subset of women with endometriosis

Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.
Fertility and sterility (Impact Factor: 4.59). 03/2009; 93(7):2137-44. DOI: 10.1016/j.fertnstert.2008.12.121
Source: PubMed


To identify potential novel biomarkers that differ between subjects with and without endometriosis and that might aid in developing a noninvasive, serum-based diagnostic test.
Case-control evaluation of a diagnostic test.
University medical center.
Consenting women of reproductive age undergoing laparoscopy for indications of pain, infertility, elective tubal ligation, tubal reanastomosis, or other benign indication.
Diagnostic laparoscopy and peripheral venipuncture.
Concentrations of low-molecular-weight proteins in serum; surgical staging of endometriosis.
Six proteins were found that were differentially expressed between those with and without disease and that had good diagnostic properties. Taken together in a two-step diagnostic algorithm, we were able to diagnose 55% of subjects, with 99% accuracy as to the status of disease. Further combining this algorithm with that derived by our previous study of serum putative markers (monocyte chemoattractant protein-1, migration inhibitory factor, leptin, and CA-125) improved our diagnostic capability to 73% of subjects, with 94% overall accuracy.
This study is the critical first step in the identification of potential novel biomarkers of endometriosis. Future identification of the proteins and further validation in a second population is needed before applying these findings in clinical practice.

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    • "The manifested symptoms of endometriosis are most commonly pelvic pain and infertility as the lesions develop and establish within the peritoneal region. Although there is a delay in the diagnosis of endometriosis, it has been noted that the most common symptoms are dysmenorrhea, pelvic pain, dyspareunia, and infertility [48]. A diagnosis of endometriosis is established in 17% of women who present with primary infertility, 5–21% of women with pelvic pain, and 50% of adolescents with dysmenorrhea [64]. "
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    • "Also, nerve samples from patients with complex regional pain syndrome (CRPS) have been analyzed in order to detect up/down regulated proteins [17]. Proteomics of serum have been used for the identification of possible biomarkers of chronic endometriosis [18], [19]. In addition, several proteomic studies have investigated human skeletal muscle exposed to high altitude [20], bed rest [21], [22], and exercise [23]. "
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