Peritoneal cytokines and adhesion formation in endometriosis: an inverse association with vascular endothelial growth factor concentration

Capsule:
The levels of peritoneal fluid vascular endothelial growth factor are inversely associated with development of pelvic adhesions in the course of endometriosis.

Authors:
Ewa Barcz, Ph.D., Łukasz Milewski, M.D., Piotr Dziunycz, M.D., Paweł Kamiński, Ph.D., Rafał Płoski, Ph.D., Jacek Malejczyk, Ph.D.
Volume 97, Issue 6 , Pages 1380-1386.e1, June 2012

Objective:
To evaluate inflammatory/angiogenic cytokines—interleukin-1β (IL-1β), IL-6, IL-8, IL-12, interferon-γ (IFN-γ), tumor necrosis factor (TNF), and vascular endothelial growth factor A (VEGF-A)—in the peritoneal fluid of patients with endometriosis in relation to the occurrence and severity of pelvic adhesions and in control women without pelvic pathology.

Design:
Case-control study.

Setting:
University research institution and hospital.

Patient(s):
Sixty-five women with laparoscopically and histopathologically confirmed endometriosis, including 40 women with pelvic adhesions, and 37 control women without pelvic pathology.

Intervention(s):
Peritoneal fluid aspirated during routine diagnostic laparoscopic examination.

Main Outcome Measure(s):
Cytokines evaluated in the peritoneal fluid via specific enzyme-linked immunosorbent assays.

Result(s):
Endometriosis and the revised American Fertility Society score of this disease were associated with statistically significantly increased levels of peritoneal IL-6 and IL-8 whereas the incidence and score of endometriosis-related pelvic adhesions were negatively associated with increased levels of VEGF-A. Notably, the concentration of VEGF-A predicted adhesion development and severity after adjustment for endometriosis severity. The adhesion score also correlated with increased levels of IL-6; however, after adjustment for endometriosis severity, the effect of this cytokine was no longer statistically significant.

Conclusion(s):
Increased levels of VEGF-A may be associated with a decreased rate of pelvic adhesion formation in the course of endometriosis.

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