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Fertil Steril. 2012 Jun;97(6):1380-6.e1. doi: 10.1016/j.fertnstert.2012.03.057. Epub 2012 Apr 28.

Peritoneal cytokines and adhesion formation in endometriosis: an inverse association with vascular endothelial growth factor concentration.

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1
Department of Obstetrics and Gynecology, Center for Biostructure Research, Medical University of Warsaw, Warsaw, Poland.

Abstract

OBJECTIVE:

To evaluate inflammatory/angiogenic cytokines-interleukin-1β (IL-1β), IL-6, IL-8, IL-12, interferon-γ (IFN-γ), tumor necrosis factor (TNF), and vascular endothelial growth factor A (VEGF-A)-in the peritoneal fluid of patients with endometriosis in relation to the occurrence and severity of pelvic adhesions and in control women without pelvic pathology.

DESIGN:

Case-control study.

SETTING:

University research institution and hospital.

PATIENT(S):

Sixty-five women with laparoscopically and histopathologically confirmed endometriosis, including 40 women with pelvic adhesions, and 37 control women without pelvic pathology.

INTERVENTION(S):

Peritoneal fluid aspirated during routine diagnostic laparoscopic examination.

MAIN OUTCOME MEASURE(S):

Cytokines evaluated in the peritoneal fluid via specific enzyme-linked immunosorbent assays.

RESULT(S):

Endometriosis and the revised American Fertility Society score of this disease were associated with statistically significantly increased levels of peritoneal IL-6 and IL-8 whereas the incidence and score of endometriosis-related pelvic adhesions were negatively associated with increased levels of VEGF-A. Notably, the concentration of VEGF-A predicted adhesion development and severity after adjustment for endometriosis severity. The adhesion score also correlated with increased levels of IL-6; however, after adjustment for endometriosis severity, the effect of this cytokine was no longer statistically significant.

CONCLUSION(S):

Increased levels of VEGF-A may be associated with a decreased rate of pelvic adhesion formation in the course of endometriosis.

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