Abstract
Endometriosis is a chronic inflammatory pathology that can cause persistent pelvic pain and infertility by affecting women of reproductive age. It is defined as the placement of endometrial tissue outside the uterine cavity. Hormonal, genetic and immunological factors have an effect on the development of endometriotic implants. Adalimumab is a monoclonal antibody specific for tumor necrosis factor alpha (TNF-á), used in the treatment of autoimmune diseases. To investigate the effectiveness of adalimumab on histopathological and biochemical values in rats with experimental endometriosis. This study is a comparative, prospective, experimental rat study. Wistar albino female rats were divided into 4 groups. Group 1 was separated as the control group. Endometriotic implants were simultaneously induced in group 2 and group 3. After 4 weeks, developing endometriotic foci were measured. Adalimumab (5 mg/kg) was simultaneously intraperitoneally (ip.) administered to group 3 and group 4 for 4 weeks. At the end of the study, histopathological scoring and fibrillin-1 scoring were performed. Total antioxidant status (TAS), total oxidant status (TOS) and malondialdehyde (MDA) values were measured. Findings in all groups were compared. When group 1 and group 2 were compared, the histopathological score, as well as MDA and TOS levels increased, while TAS levels decreased in group 2 (p < 0.001). After adalimumab treatment, the average endometriotic implant size in group 3 (0.32 ±0.002 mm) decreased compared to group 2 (0.77 ±0.04 mm) (p = 0.032). While fibrillin-1 score increased in group 2 and group 3 compared to group 1, it decreased in group 3 compared to group 2 (p < 0.001). Histopathological score decreased, TAS levels increased and MDA levels decreased in group 3 compared to group 2 (p < 0.001). Adalimumab may play a role in the regression of endometrial implants by showing antioxidant and anti-inflammatory effects on histopathological damage and fibrosis.
Highlights
Endometriosis is a chronic inflammatory pathology that can cause persistent pelvic pain and infertility by affecting women of reproductive age
When group 1 and group 2 were compared, the histopathological score, as well as MDA and total oxidant status (TOS) levels increased, while Total antioxidant status (TAS) levels decreased in group 2 (p < 0.001)
While fibrillin-1 score increased in group 2 and group 3 compared to group 1, it decreased in group 3 compared to group 2 (p < 0.001)
Summary
Endometriosis is a chronic inflammatory pathology that can cause persistent pelvic pain and infertility by affecting women of reproductive age. It is defined as the placement of endometrial tissue outside the uterine cavity. Endometriosis is a common gynecological pathology affecting 5–10% of women in the reproductive age.[1] It causes symptoms such as chronic pelvic pain, dysmenorrhea, dyspareunia, and infertility.[2] It has negative effects on ovarian reserve, tubal anatomy, embryo quality, and implantation.[3] The pathophysiology of endometriosis is still not entirely clear and several theories have been proposed. The increase in the level of IL-6 and TNF-α in the peritoneal fluid of patients with abnormal immune cell activity shows the role of cytokines in the pathogenesis.[8,9,10]
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