Abstract
Endometriosis is a disorder characterized by the presence of endometrial tissue outside the uterine cavity, primarily into the peritoneal cavity. It is known as a complex, chronic inflammatory disease and it is strongly associated with immune dysregulation. Various soluble mediators of the immune and inflammatory responses, including chemokines, play an important role in these processes. The aim of the study was to understand the role of the chemokines MCP-1, MCP-2, MCP-3, MCP-4, MIP-1 α, MIP-1β, eotaxin 2, eotaxin 3, ENA-78, and fractalkine in the development of endometriosis through their assessment in the peritoneal fluid of women with endometriosis. The study group included 58 women with endometriosis who were diagnosed during laparoscopy and then confirmed by histopathology. In 15 women from the reference group, laparoscopic examination demonstrated a normal status of the pelvic organs without any evidence of endometriosis nor inflammation in the peritoneal cavity. The peritoneal fluid of women with endometriosis and of women from the reference group were examined. To determine the concentration of the studied chemokines, enzyme immunoassays for Luminex® platforms were used. In the peritoneal fluid of women with endometriosis, a statistically significant increase in the concentration of MIP-1β, eotaxin 2, eotaxin 3, ENA-78, and fractalkine and a decrease in the concentration of MCP-1, MCP-2, MCP-3, MCP-4, and MIP-1α were observed compared to the reference group. The concentration of these cytokines depended on the severity of the disease. Changes in the concentration of the studied chemokines in the peritoneal fluid of women with endometriosis suggest their participation in the pathogenesis of the disease. The differences in chemokines concentration observed in different stages of endometriosis may be associated with the presence of inflammation in the peritoneal cavity at each step of disease development.
Highlights
The study analyzed the concentrations of the following chemokines: monocyte chemoattractant protein (MCP)-1, MCP-2, MCP-3, MCP-4, macrophage inflammatory protein (MIP)-1α, MIP-1β, eotaxin-2, eotaxin-3, epithelial-derived neutrophil activating factor (ENA)-78, and fractalkine in the peritoneal fluid of women with endometriosis and women from the reference group
The analysis showed a statistically significant decreased concentration of MCP-1, MCP-2, MCP-3, and MCP-4 in the peritoneal fluid of women with endometriosis compared to that of the reference group (p < 0.001)
The highest concentration of MCP-1 was observed in women with minimal endometriosis compared to those with mild (p < 0.001), moderate. and advanced disease, whereas the highest MCP-2 concentration was found in the PF of women with III stage disease
Summary
Endometriosis is a non-malignant gynecological disorder that affects at least 10% of women. It is characterized by the implantation and growth of endometrial-like tissue, including glands and stroma, outside the uterine cavity, most commonly in the ovaries and peritoneum in the peritoneal cavity [1]. Endometriosis is not a newly discovered disease, it still remains enigmatic. Understanding the pathophysiology of this disease is one of the challenges of gynecology and reproductive medicine. The exact mechanism of survival and proliferation of ectopic endometrial foci is unknown; numerous hypotheses and theories are trying to explain the pathogenesis of endometriosis [2]
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