Behaviour of cytokine levels in serum and peritoneal fluid of women with endometriosis
Behaviour of cytokine levels in serum and peritoneal fluid of women with endometriosis
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DOI：
10.1159/000067717
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发表时间：
2002-01-01
影响因子：
2.1
通讯作者：
Marsico, S
中科院分区：
文献类型：
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作者：
Pizzo, A;Salmeri, FM;Marsico, S
子宫内膜异位症是一种以子宫外子宫内膜组织的存在和生长为特征的疾病，主要是进入腹膜。子宫内膜异位症患者腹腔液(PF)经历了一系列生物学变化，包括局部炎症修复现象和外周血单个核细胞(PBMC)受累。这些激活的细胞和子宫内膜异位症细胞一样，分泌各种具有多效性生物学活性的细胞因子。细胞因子之间的动态相互作用可能有助于实现子宫内膜细胞植入和疾病进展的有利微环境。本研究测定了子宫内膜异位症患者外周血和血清中肿瘤坏死因子-α、转化生长因子-β、白介素8和单核细胞趋化蛋白-1等细胞因子的水平，以比较其在两种体液中的行为。26例患者均为育龄妇女，均在本院不孕症观察中心就诊，经腹腔镜检查确诊为子宫内膜异位症。对照组(n=5)为非免疫性不孕症患者，均经探查性腹腔镜确诊。S在麻醉和腹腔镜手术前采集外周血标本。在腹腔镜检查时采集PIF标本。用酶联免疫吸附试验检测两种生物体液中的细胞因子。我们的结果显示，S和Pf的肿瘤坏死因子-α水平在早期非常高，并且随着疾病的严重程度而显著下降(p<；0.001)。转化生长因子-β水平显著高于(p<；0.001)。在对照组中，并且随着疾病的严重程度而增加(p<；0.001)，特别是在PF中。S、PF、IL-8和单核细胞趋化蛋白-1浓度在各时期均高于对照组(p<；0.001)，但在两种体液中表现出相反的变化。事实上，S的IL-8和单核细胞趋化蛋白-1水平在早期显著升高(p<；0.001)，并随着疾病的严重程度而下降，而我们观察到这些趋化因子水平从I期到II期和III期显著升高(p<；0.001)。相反，单核细胞趋化蛋白-1和白介素8-S水平随病情加重而降低，而PF水平在病情加重时显著升高。综上所述，观察到的变化可能是由于腹膜巨噬细胞活性的增加以及异位内膜细胞对PBMC的大量募集和自分泌的释放。版权所有(C)2003 S.Karger AG，巴塞尔。
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-alpha (TNF-alpha), transforming growth factor-beta (TGF-beta), 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. PIF 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-alpha, not closable in controls, were very high at the early stage and decreased significantly with the severity of the disease (p < 0.001). TGF-beta 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 PIF from stage I to stage II and stage III. These observations showed that TNF-alpha and TGF-beta 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. Copyright (C) 2003 S. Karger AG, Basel.