The pathogenesis of ovarian hyperstimulation syndrome:: in vivo studies investigating the role of interleukin-1β, interleukin-6, and vascular endothelial growth factor
The pathogenesis of ovarian hyperstimulation syndrome:: in vivo studies investigating the role of interleukin-1β, interleukin-6, and vascular endothelial growth factor
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DOI：
10.1016/s0015-0282(98)00484-1
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发表时间：
1999-03-01
影响因子：
6.7
通讯作者：
Simón, C
中科院分区：
文献类型：
--
作者：
Pellicer, A;Albert, C;Simón, C
目的：评价hCG给药后全身和卵巢白细胞介素（IL）-1 β、IL-6和血管内皮生长因子（VEGF）水平的变化，以确定哪些可能是血管效应的潜在引发因素，并确定物质的主要来源;为了评价作为卵巢过度刺激综合征（OHSS）标志物的这些细胞因子的血清和卵泡液水平，并比较正常排卵妇女和多囊卵巢综合征（PCOS）妇女在基础条件下这些细胞因子的水平。设计：前瞻性对照研究。设置：体外受精程序：在Instituto Valenciano de Infertidad，瓦伦西亚，西班牙。患者：接受IVF的女性（分析了前两个研究目的），正常排卵的女性和在自然周期或刺激IUI但在诱导排卵期间取消的周期中接受未成熟卵母细胞回收的PCOS患者，干预：在hCG给药前后收集血清，并在取卵时收集卵泡液。主要结果测量：血清和卵泡液中IL-1 β、IL-6和VEGF水平。结果：有OHSS风险的患者与无OHSS风险的患者相比，hCG给药后血清VEGF水平显著升高。显著降低VEGF水平：在有风险的患者的卵泡液中发现，这种减少是区分两组的唯一有用的标志。此外，两组在基础条件下具有相似的细胞因子产生。PCOS患者血清E-2水平升高，IL-1 β、IL-6和VEGF水平降低。结论：VEGF可能是hCG在血管树上的介导者，VEGF水平的早期升高可能在OHSS的发生发展中起重要作用。卵泡液中VEGF浓度的降低是确定OHSS发生的有效标志物。PCOS患者在基础条件下细胞因子释放的模式与正常排卵的妇女无差异。（Fertil Steril（R）1999;71：482-9.（C）1999年由美国生殖医学学会出版。
Objective: To evaluate systemic and ovarian changes in levels of interleukin (IL)-1 beta, IL-6, and vascular endothelial growth factor (VEGF) in response to hCG administration to determine which may be the potential initiator of vascular effects and to identify the main source of the substance; to evaluate serum and follicular fluid levels of these cytokines as markers of ovarian hyperstimulation syndrome (OHSS), and to compare levels of these cytokines under basal conditions in women with normal ovulation and those with polycystic ovary syndrome (PCOS).Design: Prospective controlled study.Setting: In vitro fertilization program: at the Instituto Valenciano de Infertilidad, Valencia, Spain.Patient(s): Women undergoing IVF, in whom the first two study objectives were analyzed, and women with normal ovulation and patients with PCOS undergoing retrieval of immature oocytes in natural cycles or cycles stimulated for IUI but cancelled during induction of ovulation, in whom the third study objective was analyzed.Intervention(s): Serum was collected before and after hCG administration, and follicular fluid was collected at ovum pick-up.Main Outcome Measure(s): Serum and follicular fluid levels of IL-1 beta, IL-6, and VEGF.Result(s): There was a significant increase in serum VEGF levels after hCG administration in patients who were at risk for OHSS compared with those who were not at risk for OHSS. Significantly lower VEGF levels: were found in the follicular fluid of patients who were at risk; this decrease was the only useful marker to discriminate between the two groups. Moreover, both groups had similar cytokine production under basal conditions. An increase in serum E-2 occurred coincident with a decrease in IL-1 beta, IL-6, and VEGF in patients with PCOS.Conclusion(s): Vascular endothelial growth factor seems to be the mediator of hCG on the vascular tree, There was an early systemic increase id VEGF that may have significance in the development of OHSS. A decrease in the follicular fluid VEGF concentration is a valid marker to identify women in whom OHSS will develop The pattern of cytokine release in patients with PCOS under basal conditions was not different from that in women with normal ovulation. (Fertil Steril(R) 1999;71:482-9. (C)1999 by American Society for Reproductive Medicine.).