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.
Copyright © 2012 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.