Serum and peritoneal fluid cytokine comparison in women with Endometriosis

SERUM AND PERITONEAL FLUID CYTOKINE COMPARISON IN WOMEN WITH ENDOMETRIOSIS. Alfonsa Pizzo', Francesca M. Salmeri”, Vincenza Sofo”, Francesca V. Ardita', Maria T. Mastroeni' and Silvano Marsico‘. Departments of Gynaecological Sciences' and Environmental Protection”, University of Messina, Italy. Introduction: Endometriosis (E) is a disorder, common in women of reproductive age, and causes infertility, characterized by presence and growth of endometrial tissue outside of uterus, mainly in peritoneal cavity. ‘ The pathogenesis is poorly understood. Recent studies suggested that local inflammatory-reparative phenomena with peripheral blood mononuclear cells (PBMC) involvement occur in peritoneal fluid (PF) of women with E. All cell types release cytokines which realize a microenvironment favouring the implantation of endometrial cells and progression of disease. In this study we investigated the role of cytokine in PF and in serum (S) of women with E to establish a relationship between both biological fluids, ` Methods: 26 women with E identified after they laparoscopy were divided in three groups: stage I (10), stage II (10) and stage III (6). 5 women affected by non immunologic infertility undergoing explorative laparoscopy were used as controls. ,— TNFialpha, TGF-beta, IL-8 and MCP-1 cytokines were determined by ELISA kits in S and PF. • Results and Discussion: Our results evidenced that the behaviour of TNF- alpha and TGF—beta in S and PF of women with E is overlapping although opposite: TNF•aIpha_ levels decreased from stage I to stage ll and lll, whereas TGF-beta values increased from stage I to stage ll and lll in both biological fluids. By contrast MCP—1 and lL—8 level behaviour was opposite in S (decreasing with severity of disease) and PF (markedly increasing at severe stages). S and PF cytokine levels (except for TNF-alpha, not dosable ) were always significantly lower in controls. PF observed changes show a dynamic interplay among cytokines contributing to implant and growth of ectopic endometrial tissue. Early endometrial stromal cell adhesion to the extracellular matrix components could be due to TNF-alpha and chemokine increased release by circulating monocytes activated by unidentified Iactor(s). Instead, late PF chemokine and TGF•beta increase, _ due to secretion by recruited PBMC and local endometriotic cells, supports both the adhesion of endometrial stromal cells to fibronectin and neoangiogenesis, which is relevant for endometrial implants growth.