Effects of Intraperitoneal Installation of Propranolol on Vascular Smooth Muscle Cell (VEGF) Expression in Rat Model of Surgically Induced Endometriosis

Abstract

Introduction: Endometriosis is an estrogen-dependent disease affecting 8% to 10% of females of reproductive age. It is diagnosed in 71% to 87% of females with chronic pelvic pain and in 30% of women with infertility. Propranolol inhibits angiogenesis, which plays a critical role in the pathogenesis of endometriosis and could be used as a treatment modality to avoid surgery. Aim of the study: The aim of this study was to investigate whether propranolol has an inhibitory effect on the angiogenesis of endometriosis in an experimental rat model. Materials and method: Twenty-four female, non-pregnant Wistar albino rats were used to create a model for the experimental induction of endometriosis. Endometriosis was surgically induced in rats by transplanting an autologous fragment of endometrial tissue onto the inner surface of the abdominal wall. After four weeks rats underwent a second laparotomy to examine the endometrial implants for size and viability .Rats were divided into treatment (propranolol) and control groups. The rats in the control group (n = 10) received daily intraperitoneal instillation of 2 mL of saline as a vehicle solution. The injections were administered at the same time each day for 3 weeks. Rats in the treatment group (n = 10) were given 10 mg/kg of intraperitoneal propranolol daily. At the end of the 3 weeks, all rats were euthanized. Measurement of the ectopic endometriosis, Histological and immune-histopathological evaluation was conducted. Results: Treatment with propranolol reduced the size of the ectopic endometriosis. Levels of VEGF were mild in the treated group compared with sever levels in the control group. Recommendation: Beta blockers including propranolol could be one of the promising treatment modality for endometriosis. Further investigations are required to pave the way for clinical application.