Cytokines in the peritoneal fluid of patients with endometriosis

Koyama, N.; Matsuura, Kohei; Okamura, Hitoshi

doi:10.1016/0020-7292(93)90273-y

Cited by 68 publications

(21 citation statements)

References 15 publications

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“…IL-6 promotes T-cell activation and B-cell differentiation (Lebovic et al, 2001) and inhibits the proliferation of human endometrial cells . High IL-6 levels have been found in the peritoneal fluid of patients with endometriosis (Buyalos et al, 1992;Koyama et al, 1993;Keenan et al, 1994;Rier et al, 1995), and the values of IL-6 have been correlated with the degree of severity of the disease (Cheong et al, 2002;Khan et al, 2002). Serum IL-6 levels have also been assayed as a marker of endometriosis.…”

Section: Introductionmentioning

confidence: 99%

Serum interleukin-6 levels are elevated in women with minimal–mild endometriosis

Martínez¹,

Garrido²,

Coperias³

et al. 2006

Human Reproduction

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BACKGROUND: There is a need for a reliable marker of endometriosis, especially in early stages of peritoneal disease during which imaging is not effective. The use of serum interleukin (IL)-6 as a marker is controversial. To readdress the matter, patients undergoing laparoscopy were prospectively evaluated for serum IL-6 levels. MATERIALS AND METHODS: A total of 119 women 31 years old who underwent laparoscopy were divided into groups: control patients (n = 38) with no pathologic findings; endometriosis sufferers (n = 47) with minimal-mild (MM, n = 11) or moderate-severe (MS, n = 36) endometriosis; uterine myomas (n = 13) and benign ovarian pathologies (n = 21). Blood was drawn on cycles days 5-12 and stored for subsequent analysis of IL-6 and carbohydrate antigen (CA)-125 levels. RESULTS: Serum IL-6 levels were significantly (P = 0.002) higher in women with MM endometriosis (29.4 ± 9.0 pg/ml) than in controls (15.7 ± 9.3 pg/ml). When all the non-endometriosis patients were grouped together (n = 72) and serum IL-6 (17.8 ± 12.1 pg/ml) compared with MS (n = 36; 17.6 ± 10.3 pg/ml) and MM (n = 11; 29.4 ± 9.0 pg/ml) endometriosis significantly (P < 0.01) higher levels in MM endometriosis were observed as compared to the other two groups. Serum Ca-125 levels were significantly (P < 0.01) elevated in MS endometriosis. A serum IL-6 threshold of 25.75 pg/ml afforded a sensitivity of 75% and specificity of 83% in the diagnosis of MM endometriosis. Sensitivity and specificity for CA-125 in the diagnosis of MS endometriosis, using 35 IU/ml as the cut-off value, were 47% and 97%, respectively. CONCLUSIONS: IL-6 is a reliable non-invasive marker of MM endometriosis, whereas Ca-125 is of use as a marker of severe cases.

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Section: Introductionmentioning

confidence: 99%

Serum interleukin-6 levels are elevated in women with minimal–mild endometriosis

Martínez¹,

Garrido²,

Coperias³

et al. 2006

Human Reproduction

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“…The presence of such tubal disease is a strong determinant of infertility 1 ; 20 to 25% of infertile women have been shown to have endometriosis compared with 2 to 5% of fertile women 2 , and up to a third of women with endometriosis show evidence of salpingitis 3 . Whereas severe cases of endometriosis accompanied by extensive pelvic adhesions can lead to tubal infertility, mild or moderate cases with no tubal damage are also associated with infertility, suggesting an immunological rather than a mechanical barrier to reproduction 4,2 . PID also causes tubal infertility.…”

Section: Introductionmentioning

confidence: 99%

Interaction of Microbiology and Pathology in Women Undergoing Investigations for Infertility

Debattista

Gazzard²,

Wood³

et al. 2004

Infectious Diseases in Obstetrics and Gynecology

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Background: Cases of endometriosis with no tubal damage are associated with infertility, suggesting an immunological rather than mechanical barrier to reproduction. Laparoscopy and falloposcopy results of clinically asymptomatic women undergoing investigation of infertility were correlated with the outcomes of microbiological screening for Chlamydia trachomatis, Mycoplasma pneumoniae, Mycoplasma hominis, ureaplasma species, Neisseria gonorrhoeae, Neisseria meningitidis and Chlamydia pneumoniae. Methods: A total of 44 women presenting to a hospital IVF service for laparoscopic or laparoscopic/ falloposcopic investigation of infertility provided endocervical swabs, fallopian tube washings, and peripheral whole blood for analysis. Results: Of these 44 women, 15.9% (7) showed evidence of C. trachomatis infection as detected by either PCR or EIA serology. Of these 7 women, 5 (71%) had no or mild endometriosis and 2 (29%) had moderate or severe endometriosis. Of the remaining 37 women who showed no evidence of chlamydial infection, 15 (40.5%) had no or mild endometriosis. Conclusion: Women with infertility, but without severe endometriosis at laparoscopy, showed a trend towards tubal damage and a higher rate of previous C. trachomatis infection. Although not statistically significant, this trend would suggest that, where moderate to severe tubal damage is found to be the primary cause of infertility, C. trachomatis infection could be a likely cause for such tubal damage.

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“…Although extensively studied, the aetiology of endometriosis remains enigmatic: ample evidence accounts for the role played by retrograde menstruation and implantation of secretory endometrial tissue, within peritoneal cavity, in triggering and developing the disease [2]. Recent studies suggested that the peritoneal fluid (PF) of women with endometriosis undergoes a number of biological changes, including local inflammatory-reparative phenomena and peripheral blood mononuclear cells (PBMC) recruitment [3], compartmentalisation [4] and activation [5][6][7][8]. All these various cell types (i.e.…”

Section: Introductionmentioning

confidence: 99%

Behaviour of Cytokine Levels in Serum and Peritoneal Fluid of Women with Endometriosis

Pizzo

Salmeri²,

Ardita³

et al. 2002

Gynecol Obstet Invest

248

144

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Endometriosis is a disorder characterised by presence and growth of endometrial tissue outside the uterus, primarily into the peritoneum. The peritoneal fluid (PF) of women with endometriosis undergoes a number of biological changes, including local inflammatory-reparative phenomena and peripheral blood mononuclear cells (PBMC) involvement. These activated cells as well as the endometriotic cells secrete various cytokines with pleiotropic biological activities. Dynamic interplay among cytokines may contribute to realise a favourable microenvironment for the implantation of endometrial cells and the progression of the disease. In the present study, we evaluated the levels of cytokines, such as the tumour necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β), interleukin-8 (IL-8) and monocyte chemotactic protein-1 (MCP-1) in PF and in serum (S) of women with endometriosis to compare their behaviour in both biological fluids. The patients (n = 26) were women of reproductive age attending our observation centre for infertility, diagnosed endometriosis at laparoscopy. Control group (n = 5) consisted of women affected by non-immunologic infertility, diagnosed by explorative laparoscopy. S samples were obtained from peripheral blood before anaesthesia and laparoscopy. PF samples were collected at the time of laparoscopy. Both biological fluids were examined for cytokine by ELISA assays. Our results showed that S and PF levels of TNF-α, not dosable in controls, were very high at the early stage and decreased significantly with the severity of the disease (p < 0.001). TGF-β levels were significantly (p < 0.001) higher than in controls and increased with the severity of the disease (p < 0.001), particularly in the PF. S and PF IL-8 as well as MCP-1 concentrations at all stages were higher than in controls (p < 0.001), yet showed an opposite behaviour in both biological fluids. In fact, S levels of IL-8 and MCP-1 were significantly (p < 0.001) higher at early stages and decreased with the severity of the disease, whereas we observed a significant (p < 0.001) enhancement of these chemokine levels in PF from stage I to stage II and stage III. These observations showed that TNF-α and TGF-β levels were overlapping in S and PF of women with endometriosis. On the contrary, MCP-1 and IL-8 S concentrations decreased with the severity of the disease, whereas PF levels showed markedly increased at severe stages. Taken together the observed changes may be due both to the increased peritoneal macrophage activity and to the larger recruitment of PBMC and autocrine release by endometriotic cells.

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Cytokines in the peritoneal fluid of patients with endometriosis

Abstract: These findings support the concept that IL-5 and IL-6 but not IL-1 are associated with endometriosis.

Cited by 68 publications

References 15 publications

Serum interleukin-6 levels are elevated in women with minimal–mild endometriosis

Serum interleukin-6 levels are elevated in women with minimal–mild endometriosis

Interaction of Microbiology and Pathology in Women Undergoing Investigations for Infertility

Behaviour of Cytokine Levels in Serum and Peritoneal Fluid of Women with Endometriosis

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