Urokinase‐Type Plasminogen Activator and Insulin‐Like Growth Factor‐Binding Protein 3 mRNA Expression in Endometriotic Lesions and Eutopic Endometrium

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Abstract
Abstract: The peritoneal fluid of women with endometriosis contains an increased insulin‐like growth factor 1 (IGF‐1) bioavailability, which is produced by limited hydrolysis of urokinase‐type plasminogen activator (uPA) on IGF‐binding protein 3 (IGFBP‐3). Recently, IGF‐1 was shown to inhibit apoptosis of endometrial‐like cells in vitro, suggesting that a microenvironment of increased IGF‐1 bioavailability can optimize the survival of endometrial cells grown ectopically. Here the expression of mRNA of IGFBP‐3 and uPA in tissue biopsies from eutopic endometrium and endometriotic lesions obtained at laparoscopy from women with endometriosis have been analyzed, and it is documented that both IGFBP‐3 and uPA mRNA expression are increased from 3‐ to 10‐fold in endometriotic lesions versus eutopic endometrium. Consequently, the necessary components (uPA and IGFBP‐3 expression) of endocrine/autocrine/paracrine enhancement of local IGF bioavailability mediated by uPA hydrolysis of the IGFBP‐3 were present in endometriotic lesions. These data possibly explain the origin of the increased content of uPA activity, IGF‐1 bioavailability, and NH2‐truncated forms of IGFBP‐3 in the peritoneal fluid of women with endometriosis.