Plasma and Peritoneal Fluid Fibronectin and Collagen IV Levels as Potential Biomarkers of Endometriosis

Abstract

Laparoscopy as a diagnostic tool for patients with suspected endometriosis is associated with several potentially life-threatening complications. Therefore, it is imperative to identify reliable, non-invasive biomarkers of the disease. The aim of this study was to analyse the concentrations of fibronectin and type IV collagen in peritoneal fluid and plasma to assess their role as potential biomarkers in the diagnosis of endometriosis. Fibronectin and collagen IV protein levels were assessed by surface plasmon resonance imaging (SPRi) biosensors with the usage of monoclonal antibodies. All patients enrolled in the study were referred for laparoscopy for the diagnosis of infertility or chronic pelvic pain (n = 84). The study group included patients with endometriosis confirmed during surgery (n = 49). The concentration of fibronectin in the plasma (329.3 ± 98.5 mg/L) and peritoneal fluid (26.8 ± 11.1 μg/L) in women with endometriosis was significantly higher than in the control group (251.2 ± 84.0 mg/L, 7.0 ± 5.9 μg/L). Fibronectin levels were independent of endometriosis stage (p = 0.874, p = 0.469). No significant differences were observed in collagen IV levels (p = 0.385, p = 0.465). The presence of elevated levels of fibronectin may indicate abnormalities in cell–ECM signalling during the course of endometriosis, and may be a potential biomarker for early detection.

Single-cell characterization of menstrual fluid at homeostasis and in endometriosis

“…At the protein level, studies comparing eutopic and ectopic endometrium from patients have yielded contradictory results (39). However, fibronectin levels in plasma and peritoneal fluid have consistently reported elevated levels in endometriosis patients when compared to healthy women (40,41).…”

The Holy Grail of endometriosis biomarkers in the diagnostic process – How much would it be worth and what does it look like?

“…Differences in fibronectin levels between samples collected from women with endometriosis and controls might demonstrate the potential role of extracellular matrix signaling pathways in the pathophysiology of endometriosis. [38][39][40][41] Béliard et al 38 compared the expression of laminin and fibronectin together with their receptors in endometriotic lesions and endometrial tissue samples of 18 patients with endometriosis. The findings showed that the expression of fibronectin receptors was present only in the ectopic endometriosis tissue samples and undetected in the eutopic endometrial tissue.…”

Relaxed fibronectin: a potential novel target for imaging endometriotic lesions

“…While Béliard et al found no difference in Fn expression between the eutopic and ectopic endometrium [ 20 ], Holzer et al found decreased Fn expression in the eutopic endometrium [ 18 ] and Zhang et al reported increased Fn expression in the ectopic endometrium [ 21 ]. Despite the apparent controversy of Fn expression in eutopic and ectopic endometrium, Fn levels in plasma [ 22 , 23 ] and peritoneal fluid [ 23 ] from endometriosis patients are consistently reported as elevated compared to healthy women.…”