Review Article

Angiogenesis and Endometriosis

Table 1

Antiangiogenic agents.

ā€‰Antiangiogenic agentsFunctional activity (in vivo and in vitro studies)

VEGF blockers and inhibitors Soluble truncated VEGF receptors (Flt-1)Inhibited the growth of human endometrium in mice
Anti-human VEGF antibodyInhibited the growth of human endometrium and decreased the number of endometriotic lesions
TNP-470 (lodamin)Inhibited the number of endometriosis lesions, suppressed the mobilization of circulating endothelial cells and endothelial progenitor cells
Endostatin and anginexInhibited the number of endometriosis lesions
Bevacizumab (recombinant humanized monoclonal antibody that inhibits VEGF) Inhibited the development and cell proliferation in endometriotic lesions, reduced vascular density, increased apoptosis, and reduced VEGF levels
Sorafenib (an orally active multikinase inhibitor)Interfered with the activity of the VEGF receptor reducing the microvessel density and lesion volume of endometrial implants
Romidepsin (a histone deacetylase inhibitor)Inhibited VEGF gene transcription, protein expression and secretion of VEGF
Lipoxin A4 (LXA4, an endogenous eicosanoid)Reduced the endometriosis lesion size and downregulated inflammation-associated proteins, including IL-6 VEGF and matrix metalloproteinase 9
4-Hydroxybenzyl alcohol (HBA, a naturally occurring phenolic compound)Inhibited the initiation of the angiogenic process by downregulating VEGF and matrix-metalloproteinase-(MMP-) 9 expression and by affecting endothelial cell migration
Parecoxib (selective COX-2 inhibitor)Reduced lesion size, microvessel density, the number of macrophages, and the expression of VEGF
Epigallocatechin gallate (major constituent of green tea)Decreased endometriotic lesion size, microvessel diameter and density, and VEGF mRNA expression
SU6668Suppressed angiogenesis and vessel maturation in endometriotic lesions.
Macrophage migration inhibitory factor (MIF) antagonistReduced the expression of VEGF, cell adhesion receptors, MMP-2, MMP-9, IL-8, cyclooxygenase (COX)2

Other anti-angiogenic agents Xanthohumol (a prenylated flavonoid)Inhibited the formation of new blood vessels
Rapamycin (an immunosuppressant drug)Inhibited neovascularization and cell proliferation
Retinoic acidDecreased the volume of endometriotic implants
Progestogens (progesterone, dydrogesterone, or its metabolite dihydrodydrogesterone)Reduced proliferation of endometrial stromal cells and suppressed the transcription of VEGF-A and the microvessel density
Statins (atorvastatin, lovastatin)Inhibited the inflammatory and angiogenic genes COX-2 and VEGF in endometriotic stromal cells
Dopamine agonistsReduced microvessel density and angiogenic gene expression