Features of cytokine production at the systemic and local level in patients of reproductive age with external genital endometriosis

Objective: to establish the features of cytokine production in patients of reproductive age with external genital endometriosis at various stages of the disease.

Materials and methods: the study included 52 patients with external genital endometriosis (EGE). Group I consisted of 31 patients with stages I–II of EGE, group II — 21 patients with stages III–IV of the disease, control group — 20 women without endometriosis. Serum samples were obtained before anesthesia, and peritoneal fluid (PF) samples were obtained during endoscopic examination of patients. Determination of the content of cytokines in blood serum and peritoneal fluid was carried out by enzyme immunoassay using a multifunctional counter for enzyme immunoassays with Victor software (Finland). TNF-α, IL-10 — using reagents from BenderMed Systems (Austria). IL-13, IL-18 using reagents from Cloud-CloneCorp (USA) according to the manufacturer’s recommendations. Application software packages (Megastat and Statistica 10.0) were used to create a database and conduct statistical research. To determine statistical differences between groups, the Mann-Whitney test was used for independent groups and the Wilcoxon test for dependent groups. P values less than 0.05 were considered statistically significant. Data are presented as median and quartiles.

Results: at stages I–II of EGE, an increase in the level of TNF-α, IL-18 was detected in the blood serum and peritoneal fluid, which can stimulate proliferation, invasion of endometrial cells and neovascularization; stage III–IV of the disease was characterized by an increase in the level of TNF-α, IL-10, IL-13 in the peritoneal fluid, which promotes disease progression by evading ectopic endometrial cells from immune control.

Conclusion: the identified features of the production of pro- and anti-inflammatory cytokines at the systemic and local level at various stages of EGE confirm their importance in the development of the disease. Further research is needed to understand the mechanisms underlying the progression of NGE and to develop methods for early diagnosis.

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