Abnormal Th17 pathway in infertile patients with minimal/mild endometriosis

Abstract

OBJECTIVE: To evaluate Th1/Th2 and Th17 pathways measuring serum and peritoneal interleukins (IL)-10, IL-12, IL-17 and IL-23 levels of women with and without endometriosis.DESIGN: Cross-sectional survey in an university hospital.MATERIALS AND METHODS: Interleukin-10, IL-12, IL-17 and IL-23 levels were measured in 40 patients submitted to laparoscopy as part of an investigation on infertility (study group), as well as in 40 fertile patients submitted to lapararoscopy for tubal ligation (control group). Minimal or mild endometriosis was confirmed in the study group and endometriosis was excluded from the control group. Blood sample and peritoneal fluid were obtained from patients during video laparoscopy. Levels of IL-10, IL-12, IL-17 and IL-23 in peripheral blood and peritoneal fluid were determined by enzyme immunoassay and compared between groups.RESULTS: IL-23 levels measured in peritoneal fluid were higher in patients with endometriosis compared with the control group. This difference was not demonstrated in the serum for IL-23. No statistically significant differences were found in IL-10, IL-12 and IL-17 levels, either in serum or in peritoneal fluid samples.CONCLUSION: Patients with minimal or mild endometriosis and infertility have higher peritoneal IL-23 levels irrespective of the other cytokines measured, suggesting that in this disease an alternative pathway is involved in induction of the Th2 immune response, possibly trough Th17 cells. This imbalance could contribute to these patients' infertility. OBJECTIVE: To evaluate Th1/Th2 and Th17 pathways measuring serum and peritoneal interleukins (IL)-10, IL-12, IL-17 and IL-23 levels of women with and without endometriosis. DESIGN: Cross-sectional survey in an university hospital. MATERIALS AND METHODS: Interleukin-10, IL-12, IL-17 and IL-23 levels were measured in 40 patients submitted to laparoscopy as part of an investigation on infertility (study group), as well as in 40 fertile patients submitted to lapararoscopy for tubal ligation (control group). Minimal or mild endometriosis was confirmed in the study group and endometriosis was excluded from the control group. Blood sample and peritoneal fluid were obtained from patients during video laparoscopy. Levels of IL-10, IL-12, IL-17 and IL-23 in peripheral blood and peritoneal fluid were determined by enzyme immunoassay and compared between groups. RESULTS: IL-23 levels measured in peritoneal fluid were higher in patients with endometriosis compared with the control group. This difference was not demonstrated in the serum for IL-23. No statistically significant differences were found in IL-10, IL-12 and IL-17 levels, either in serum or in peritoneal fluid samples. CONCLUSION: Patients with minimal or mild endometriosis and infertility have higher peritoneal IL-23 levels irrespective of the other cytokines measured, suggesting that in this disease an alternative pathway is involved in induction of the Th2 immune response, possibly trough Th17 cells. This imbalance could contribute to these patients' infertility.