Wu Gengxiang, Bersinger N A, Mueller M D, von Wolff M
Division of Gynaecological Endocrinology and Reproductive Medicine, University Women's hospital, Effingerstrasse 102, 3010, Bern, Switzerland.
Reproductive Medical Centre, Renmin Hospital of Wuhan University, Wuhan, China.
J Assist Reprod Genet. 2017 Mar;34(3):357-364. doi: 10.1007/s10815-016-0865-3. Epub 2017 Jan 10.
The aim of this study was to assess whether the intrafollicular cytokine profile in naturally developed follicles is different in women with endometriosis, possibly explaining the lower reproductive outcome in endometriosis patients.
A matched case-control study was conducted at a university-based infertility and endometriosis centre. The study population included 17 patients with laparoscopically and histologically confirmed endometriosis (rAFS stages II-IV), each undergoing one natural cycle IVF (NC-IVF) treatment cycle between 2013 and 2015, and 17 age-matched NC-IVF women without diagnosed endometriosis (control group). Follicular fluid and serum was collected at the time of follicle aspiration. The concentrations of inflammatory cytokines (IL-1β, IL-6, IL-8, IL-15, IL-18, TNF-α) and hormones (testosterone, estradiol, AMH) were determined in follicular fluid and serum by single or multiplexed immunoassay and compared between both groups.
In the follicular fluid, IL-1β and IL-6 showed significantly (P < 0.001 and 0.01, respectively) higher median concentrations in the endometriosis group than in the control group and a tendency towards endometriosis severity (rAFS stage) dependence. The levels of the interleukins detectable in follicular fluid were significantly higher than those in the serum (P < 0.01). Follicular estradiol concentration was lower in severe endometriosis patients than in the control group (P = 0.036). Follicular fluid IL-1β and IL-6 levels were not correlated with estradiol in the same compartment in neither patient group.
In women with moderate and severe endometrioses, some intrafollicular inflammatory cytokines are upregulated and not correlated with intrafollicular hormone concentrations. This might be due to the inflammatory microenvironment in endometriosis women, affecting follicular function and thereby possibly contributing to the reproductive dysfunction in endometriosis.
本研究旨在评估自然发育卵泡内的细胞因子谱在子宫内膜异位症患者中是否存在差异，这可能解释了子宫内膜异位症患者较低的生殖结局。
在一所大学附属的不孕不育与子宫内膜异位症中心进行了一项匹配病例对照研究。研究人群包括17例经腹腔镜和组织学确诊为子宫内膜异位症（rAFS分期II-IV期）的患者，每位患者在2013年至2015年间接受一个自然周期体外受精（NC-IVF）治疗周期，以及17例年龄匹配的未诊断为子宫内膜异位症的NC-IVF女性（对照组）。在卵泡抽吸时收集卵泡液和血清。通过单或多重免疫测定法测定卵泡液和血清中炎性细胞因子（IL-1β、IL-6、IL-8、IL-15、IL-18、TNF-α）和激素（睾酮、雌二醇、AMH）的浓度，并在两组之间进行比较。
在卵泡液中，IL-1β和IL-6在子宫内膜异位症组中的中位浓度显著高于对照组（分别为P < 0.001和0.01），并且有随子宫内膜异位症严重程度（rAFS分期）增加的趋势。卵泡液中可检测到的白细胞介素水平显著高于血清中的水平（P < 0.01）。重度子宫内膜异位症患者的卵泡雌二醇浓度低于对照组（P = 0.036）。在两个患者组中，卵泡液IL-1β和IL-6水平与同一隔室内的雌二醇均无相关性。
在中重度子宫内膜异位症女性中，一些卵泡内炎性细胞因子上调且与卵泡内激素浓度无关。这可能是由于子宫内膜异位症女性的炎性微环境影响卵泡功能，从而可能导致子宫内膜异位症患者的生殖功能障碍。
