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Fertil Steril. 2014 Jan;101(1):242-7. doi: 10.1016/j.fertnstert.2013.09.041. Epub 2013 Dec 5.

Interleukin-6, interleukin-1β, and tumor necrosis factor α in menstrual effluents as biomarkers of chronic endometritis.

Author information

1
Dipartimento Interdisciplinare di Medicina, University of Bari, Bari, Italy.
2
Dipartimento di Scienze Biomediche ed Oncologia Umana, University of Bari, Bari, Italy.
3
Dipartimento di Scienze Biomediche ed Oncologia Umana, University of Bari, Bari, Italy. Electronic address: ettore.cicinelli@uniba.it.

Abstract

OBJECTIVE:

To assess the relationship between chronic endometritis (CE) and proinflammatory cytokine levels in menstrual effluents and to develop a simple noninvasive test for screening CE.

DESIGN:

Case-control study.

SETTING:

Academic center.

PATIENT(S):

Sixty-four women referred to our center for infertility.

INTERVENTION(S):

Office hysteroscopy; endometrial biopsy; collection of menstrual blood at subsequent cycle.

MAIN OUTCOME MEASURE(S):

Interleukin (IL) 6, IL-1β, and tumor necrosis factor (TNF) α concentrations in menstrual effluents.

RESULT(S):

Thirty-six out of 64 infertile women had histologically proven CE. The remaining 28 women were included as controls. IL-6, IL-1β, and TNF-α levels were markedly higher in menstrual effluents of women with CE compared with control subjects. Receiver operating characteristic curve analysis revealed a good CE screening capacity for all of the cytokines. The combined evaluation of either IL-6/TNF-α or IL-6/IL-1β increased the diagnostic capacity of the test, which reached a 100% sensitivity and a negative predictive value of 100 when at least one cytokine was found to exceed its cutoff value; it also reached a 100% specificity and a positive predictive value of 100 in cases of positivity of both cytokines. Logistic regression analysis confirmed the IL-6/TNF-α-based model as a significant predictor of CE.

CONCLUSION(S):

Proinflammatory cytokine levels are increased in menstrual effluents of women with CE. A test dosing IL-6 and TNF-α seems to have a high screening capacity for CE.

KEYWORDS:

Chronic endometritis; IL-1β; IL-6; TNF-α; cytokines; menstrual effluents

[Indexed for MEDLINE]

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