Department of Gynecology Obstetrics II and Reproductive Medicine, Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, AP-HP, Hôpital Cochin, 75679 Paris, France.
Hum Reprod. 2012 Jul;27(7):2001-9. doi: 10.1093/humrep/des154. Epub 2012 May 15.
Interleukin 33 (IL-33) is a cytokine involved in fibrotic disorders. We have analyzed IL-33 levels in the sera and peritoneal fluids of women with various forms of endometriosis and investigated the correlation with disease activity.
We conducted a prospective laboratory study in a tertiary-care university hospital between January 2005 and December 2010. Five hundred and ten women with histologically proven endometriosis and 132 endometriosis-free controls were enrolled in this study. Complete surgical exploration of the abdominopelvic cavity was performed in each patient. Blood samples and peritoneal fluids were obtained before and during surgical procedures, respectively. IL-33 was measured by an enzyme-linked immunosorbent assay in sera and peritoneal fluids, and the concentrations correlated with the extent and the severity of endometriotic lesions.
IL-33 was detectable in 23.1% of serum samples from all 642 women studied and 75.0% of peritoneal fluid samples studied (44 women with endometriosis and 36 controls). Serum IL-33 was higher in deeply infiltrating endometriosis (DIE) (median, 104.9 pg/ml; range, 8.0-104.9) than in endometriosis-free women (median, 61.3 pg/ml; range, 7.5-526.0; P = 0.022) or in women affected by superficial endometriosis (median, 36.8 pg/ml; range, 7.5-179.0; P < 0.001). Peritoneal IL-33 was higher in DIE than in endometriosis-free women (median, 642.0 pg/ml; range, 25.9-3350.6 versus median, 194.2 pg/ml; range, 12.7-1818.2, respectively; P = 0.003). We found positive correlations between serum IL-33 concentration and intensity of dysmenorrhea (r = 0.174; P = 0.028) and gastrointestinal symptoms (r = 0.199; P = 0.027), total number of DIE lesions (r = 0.224; P = 0.016) and the worst DIE lesion (r = 0.299; P < 0.001).
In spite of the number of samples with undetectable levels, serum IL-33 is abnormally elevated in women with endometriosis and principally in DIE. Elevated serum IL-33 is correlated with the intensity of preoperative painful symptoms, and with the extent and severity of the DIE. IL-33 may be considered as a novel cytokine involved in the pathogenesis of DIE.
白细胞介素 33（IL-33）是一种参与纤维化疾病的细胞因子。我们分析了不同形式子宫内膜异位症女性的血清和腹腔液中的 IL-33 水平，并研究了其与疾病活动度的相关性。
我们在 2005 年 1 月至 2010 年 12 月期间在一家三级护理大学医院进行了一项前瞻性实验室研究。本研究纳入了 510 名经组织学证实患有子宫内膜异位症的女性和 132 名无子宫内膜异位症的对照者。每位患者均进行了全腹盆腔的彻底探查。分别在手术前和手术过程中采集血样和腹腔液。通过酶联免疫吸附试验在血清和腹腔液中测量 IL-33，其浓度与子宫内膜异位症病变的范围和严重程度相关。
在研究的 642 名女性中，有 23.1%的血清样本和 75.0%的腹腔液样本可检测到 IL-33（44 名子宫内膜异位症患者和 36 名对照者）。深度浸润性子宫内膜异位症（DIE）患者的血清 IL-33 水平高于无子宫内膜异位症的女性（中位数，104.9 pg/ml；范围，8.0-104.9）和患有浅表性子宫内膜异位症的女性（中位数，36.8 pg/ml；范围，7.5-179.0；P = 0.022）。DIE 患者的腹腔液 IL-33 水平高于无子宫内膜异位症的女性（中位数，642.0 pg/ml；范围，25.9-3350.6 与中位数，194.2 pg/ml；范围，12.7-1818.2；P = 0.003）。我们发现血清 IL-33 浓度与痛经强度（r = 0.174；P = 0.028）和胃肠道症状（r = 0.199；P = 0.027）、DIE 病变总数（r = 0.224；P = 0.016）和最严重的 DIE 病变（r = 0.299；P < 0.001）呈正相关。
尽管有相当数量的样本检测不到 IL-33 水平，但子宫内膜异位症女性的血清 IL-33 水平异常升高，尤其是 DIE 患者。血清 IL-33 升高与术前疼痛症状的强度以及 DIE 的范围和严重程度相关。IL-33 可能被认为是一种参与 DIE 发病机制的新型细胞因子。
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