A tumor necrosis factor α inhibitor reduces the embryotoxic effects of endometriotic peritoneal fluid

Capsule:
The abundant TNF-a in the peritoneal fluid of women with endometriosis plays an important role in endometriosis-induced embryotoxicity. The TNF-a inhibitors could potentially be used to treat endometriosis-related infertility.

Authors:
Yi-Jen Chen, M.D., Ph.D., Hua-Hsi Wu, M.D., Wan-Ting Liau, Chang-Youh Tsai, M.D., Ph.D., Hsiao-Wen Tsai, M.D., Ming-Shyen Yen, M.D., Kuan-Chong Chao, M.D., Yen-Jen Sung, M.D., Ph.D., Hsin-Yang Li, M.D., Ph.D.

Volume 100, Issue 5, Pages 1476-1485.e5, November 2013

Abstract:

Objective:
To determine whether a tumor necrosis factor-α (TNF-α) inhibitor can reduce the embryotoxicity of the peritoneal fluid (PF) of women with endometriosis.

Design:
Experimental clinical study.

Setting:
University hospital.

Patient(s):
Twelve women with chocolate cysts and 12 control women without endometriosis.

Intervention(s):
None.

Main Outcome Measure(s):
We collected the PF from patients with chocolate cysts (CH-PF) and patients without endometriosis (N-PF) during laparoscopic surgery. For the in vitro studies, development and apoptosis were evaluated in two-cell stage mouse embryos after incubation with CH-PF and N-PF, with or without a TNF-α inhibitor.

Result(s):
We found that CH-PF significantly decreased the rate of blastocyst development and increased the percentage of apoptotic cells in the embryos. Cytokine assays showed that the concentrations of several cytokines, including TNF-α, were higher in embryos incubated with CH-PF than in those incubated with N-PF. Furthermore, the treatment of embryos with TNF-α retarded development and induced apoptosis. Important, adalimumab, a TNF-α inhibitor, effectively abrogated the embryotoxicity that was induced by CH-PF.

Conclusion(s):
These data collectively highlight the crucial role of TNF-α in CH-PF-induced embryotoxicity and suggest that TNF-α inhibitors may be potential therapeutic agents for treating endometriosis-induced infertility.

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