Abstract
Interleukin-18 (IL-18) is a cytokine that belongs to the IL-1 family. Endometriosis is strongly associated with sub-fertility, and affects about 15% of women of reproductive age. IL-18 may favor the progression of endometriosis. The objective of the present study was to determine the concentration of IL-18 in the serum and peritoneal fluid of infertile women with endometriosis. Forty infertile and 25 fertile women were screened in a teaching hospital. Thirty-four infertile patients with minimal or mild endometriosis and 22 fertile controls were enrolled in the study. The primary outcome was the estimate of IL-18 levels and the secondary outcome was the correlation between serum and peritoneal levels of IL-18. There were no differences between the two groups regarding age, body mass index and levels of peritoneal fluid IL-18 (mean +/- SD): 290.85 +/- 173.02 pg/mL for infertile women vs 374.21 +/- 330.15 pg/mL for controls; or serum IL-18: 391.07 +/- 119.71 pg/mL for infertile women vs 373.42 +/- 129.11 pg/mL for controls. However, a positive association was found between serum and peritoneal IL-18 levels in patients with endometriosis: r = 0.794, P = 0.0001. All measurements were carried out at the same time by the Human IL-18 Immuno Assay ELISA kit (MBL Co. Ltd., Japan). The present study did not find evidence supporting the hypothesis that IL-18 levels are associated with infertility in women with minimal and mild endometriosis, although a positive correlation was detected in these women between peritoneal and serum levels of IL-18.
Highlights
The association between endometriosis and infertility is well known
Interleukin-18 (IL-18) is a cytokine that belongs to the IL-1 family, originally identified as interferon gamma (IFN-γ) in Kupffer cells and macrophages [7]
This study did not find a significant difference in the IL-18 levels of serum and the peritoneal cavity of infertile women with minimal and mild endometriosis compared to the control group
Summary
The association between endometriosis and infertility is well known. It has been estimated that about 20-25% of infertile women have endometriosis [1,2]. For infertile women with minimal or mild endometriosis, the cause of infertility is not fully understood but is thought to involve hormonal [3,4], immunological [5], proliferative (endometrial), and uterine alterations [2,6]. IL-18 activates natural killer (NK) cells and plays a relevant role in the protection against bacterial infections. It plays a central role in the inflammatory cascade and in the process of innate and acquired immunity as a result of its ability to induce the production of IFN-γ in T lymphocytes and NK cells [7,8]
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