Interleukin 6 interleukin 1β and tumor necrosis factor α in menstrual effluents as biomarkers of chronic endometritis

Capsule:
Proinflammatory cytokines are increased in menstrual effluents of women with chronic endometritis (CE). A test measuring interleukin-6 and tumor necrosis factor a might offer a reliable tool for screening CE.

Authors:
Cosimo Tortorella, M.D., Ph.D., Giuseppina Piazzolla, M.D., Maria Matteo, M.D., Vincenzo Pinto, M.D., Raffaele Tinelli, M.D., Carlo Sabbà, M.D., Margherita Fanelli, Ettore Cicinelli, M.D.

Volume 101, Issue 1, Pages 242-247, January 2014

Abstract:

Objective:
To assess the relationship between chronic endometritis (CE) and proinflammatory cytokine levels in menstrual effluents and to develop a simple noninvasive test for screening CE.

Design:
Case-control study.

Setting:
Academic center.

Patient(s):
Sixty-four women referred to our center for infertility.

Intervention(s):
Office hysteroscopy; endometrial biopsy; collection of menstrual blood at subsequent cycle.

Main Outcome Measure(s):
Interleukin (IL) 6, IL-1β, and tumor necrosis factor (TNF) α concentrations in menstrual effluents.

Result(s):
Thirty-six out of 64 infertile women had histologically proven CE. The remaining 28 women were included as controls. IL-6, IL-1β, and TNF-α levels were markedly higher in menstrual effluents of women with CE compared with control subjects. Receiver operating characteristic curve analysis revealed a good CE screening capacity for all of the cytokines. The combined evaluation of either IL-6/TNF-α or IL-6/IL-1β increased the diagnostic capacity of the test, which reached a 100% sensitivity and a negative predictive value of 100 when at least one cytokine was found to exceed its cutoff value; it also reached a 100% specificity and a positive predictive value of 100 in cases of positivity of both cytokines. Logistic regression analysis confirmed the IL-6/TNF-α–based model as a significant predictor of CE.

Conclusion(s):
Proinflammatory cytokine levels are increased in menstrual effluents of women with CE. A test dosing IL-6 and TNF-α seems to have a high screening capacity for CE.

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