The effect of antiangiogenic agent aflibercept on surgically induced endometriosis in a rat model




Caglayan Ates, Department of Obstetrics and Gynecology, University of Health Sciences, Etlik Zubeyde Hanim Training and Research Hospital, Ankara, Turkey
Berna Dilbaz, Department of Reproductive Endocrinology and Infertility, University of Health Sciences, Etlik Zubeyde Hanim Training and Research Hospital, Ankara, Turkey
Seval Yılmaz Ergani, Department of Obstetrics and Gynecology, University of Health Sciences, Etlik Zubeyde Hanim Training and Research Hospital, Ankara, Turkey
Fuad Atabay, Department of Pathology, University of Health Sciences, Gulhane Training and Research Hospital. Ankara, Turkey


Objective: The aim of the study is to show for the first time how aflibercept affects endometriosis lesions. Material and methods: Surgically induced endometriosis in Wistar albino female rats. Rats with endometriosis were randomly divided into three groups: control (Co), aflibercept (Af), and leuprolide acetate (Le). Then, Af, aflibercept, and Le received leuprolide acetate. The control group was not treated. The weights and changes in intra-abdominal adhesions of the rats before and after treatment were recorded according to the Blauer adhesion score. Blood extracted for sacrifice was analyzed. Endometriotic lesions were evaluated for size, volume, histology, and immunohistochemistry (vascular endothelial growth factor [VEGF] and CD31). Significance level was accepted as p < 0.05. Results: Aflibercept significantly reduced endometrial implant volume (p = 0.002). The explant epithelial histological score showed a significant difference between aflibercept and leuprolide acetate (p = 0.006) and between aflibercept and control groups (p = 0.002). Aflibercept decreased VEGF-H and CD31 expression (p = 0.001) more than leuprolide acetate. Aflibercept improved adhesions (p = 0.006). Conclusion: Aflibercept is more successful than leuprolide acetate in the treatment of endometriosis.



Keywords: Aflibercept. Leuprolide acetate. Angiogenesis. Endometriosis. Vascular endothelial growth factor