Evaluation of the content and the pathogenetic role of cytokines in the peritoneal fluid in patients with deep infiltrative endometriosis

Abstract

Background. Deep infiltrative endometriosis (DIE) is characterized by the invasion of endometriosis lesions in tissues and organs to a depth of over 5 mm. In recent years, the proportion of infiltrative forms of endometriosis has been steadily increasing. The main clinical manifestations is chronic pelvic pain syndrome and infertility. A key element in the pathogenesis of deep infiltrative endometriosis is an ineffective inflammatory response.Objective. Evaluate the content and the role of pro- and anti-inflammatory cytokines, growth factors and chemokines in the pathogenesis of deep infiltrative endometriosis for pathogenetically grounded immunomodulatory therapy.Materials and methods. The present study included 120 women with deep infiltrative endometriosis. In the peritoneal fluid, using IFA determined the level of IL-33, and with the help of running cytofluometry format NEA has estimated the levels of IL-2, IL-6, IL-10, IP-10, MCP-1 and growth factors – FGF, TGF-β.Results. In the study of peritoneal fluid of patients with DIE was a significant decrease in the level of IL-2 and IL-10 6.7 times compared to the control group. The level of IL-6 was increased in 1.5 times, as well as the level of IL-33, and was awarded the data link cytokines with the severity of pain. DIE is characterized by increased levels of MCP-1 in 2 times and decrease in IP-10 1.3 times, as well as increased levels of FGF 1.5 times and reduced levels of TGF-β in 1.9 times in comparison with the control group.Conclusion. For effective treatment of DIE and to increase the duration of recurrence-free period actual and pathogenetically justified is the inclusion of a combined treatment of immunomodulatory therapy with recombinant IL-2 aimed at the elimination of immunological disorders in the pelvic cavity.

Matrix Metalloproteinases in the Genesis of External Genital Endometriosis

“…Рядом авторов показана важная роль цитокинов в перечисленных выше процессах, а именно: интерлейкинов (IL) -IL-1, IL-4, IL-6, IL-8, IL-10; факторов роста -трансформирующего фактора роста (TGF), фактора некроза опухоли (TNF-α), фактора роста эндотелия сосудов (VEGF), которые регулируют ремоделирование межклеточного матрикса [1,3,6]. Кроме того, доказано, что IL-1 в эндотелиоцитах стимулирует выработку ММР-9, а индуктором синтеза ММР-9 в этих клетках является VEGF [6], экспрессия которого запускается с помощью IL-6 [3]. Вместе с этим IL-4 и IL-10 через подавление синтеза IL-1 в макрофагах индуцируют биосинтез ММР-9.…”

“…Вместе с этим IL-4 и IL-10 через подавление синтеза IL-1 в макрофагах индуцируют биосинтез ММР-9. Помимо этого, рядом исследователей обнаружена способность ММР-9 активировать IL-8 и трансформирующий фактор роста бета (TGF-ß), который обладает способностью угнетать пролиферацию эндотелиальных клеток [6,7].…”