Department of Obstetrics & Gynecology, Milas Government Hospital, Muğla, Turkey.
Department of Obstetrics & Gynecology, Assisted Reproductive Technology Unit, Şişli Kolan International Hospital, İstanbul, Turkey.
J Reprod Immunol. 2021 Aug;146:103340. doi: 10.1016/j.jri.2021.103340. Epub 2021 May 29.
The pathophysiology of endometriosis is still unknown and treatment options remain controversial. Searches focus on angiogenesis, stem cells, immunologic and inflammatory factors. This study investigated the effects of etanercept and cabergoline on ovaries, ectopic, and eutopic endometrium in an endometriosis rat model. This randomized, placebo-controlled, blinded study included 50 rats, Co(control), Sh(Sham), Cb(cabergoline), E(etanercept), and E + Cb(etanercept + cabergoline) groups. After surgical induction of endometriosis, 2 operation was performed for endometriotic volume and AMH level. After 15 days of treatment: AMH level, flow cytometry, implant volume, histologic scores, immunohistochemical staining of ectopic, eutopic endometrium, and ovary were evaluated at 3 operation. All groups had significantly reduced volume, TNF-α, VEGF, and CD 146/PDGF-Rβ staining of endometriotic implants comparing to the Sh group (p < 0.05).TNF-α staining of eutopic endometrium in all treatment groups was similar to Sh and Co groups (p > 0.05). E and E + Cb groups significantly decreased TNF-α staining in the ovary comparing to Sh, Co, and Cb groups (p < 0.05). All treatment groups had significantly higher AFC compared to the Sh group. CD25 Cells' median percentage was significantly increased in the E + Cb group compared to Co, Sh, Cb, and E group. E + Cb group had a significantly higher CD5 Cells' level than the Co group (p = 0.035). In conclusion; Etanercept and/or Cabergoline decreased volume, TNF-α, VEGF, and CD 146/PDGF-Rβ staining of the ectopic endometrial implant. E and E + Cb treatment decreased TNF-α levels in the ovary. E + Cb also increased peripheral blood CD25 & CD5 Cell's.
内异症的病理生理学仍然未知，治疗选择仍存在争议。研究集中在血管生成、干细胞、免疫和炎症因子上。本研究旨在探讨依那西普和卡麦角林对子宫内膜异位症大鼠模型卵巢、异位和在位子宫内膜的影响。这是一项随机、安慰剂对照、盲法研究，纳入了 50 只大鼠，分为 Co（对照组）、Sh（假手术组）、Cb（卡麦角林组）、E（依那西普组）和 E + Cb（依那西普+卡麦角林组）。在手术诱导子宫内膜异位症后，进行了两次手术以评估异位内膜体积和 AMH 水平。治疗 15 天后，进行了第三次手术以评估 AMH 水平、流式细胞术、种植体体积、组织学评分、异位和在位子宫内膜及卵巢的免疫组化染色。与 Sh 组相比，所有组的异位内膜种植体体积、TNF-α、VEGF 和 CD146/PDGF-Rβ 染色均显著降低（p < 0.05）。所有治疗组的在位子宫内膜 TNF-α染色与 Sh 组和 Co 组相似（p > 0.05）。与 Sh、Co 和 Cb 组相比，E 和 E + Cb 组的卵巢 TNF-α染色显著降低（p < 0.05）。与 Sh 组相比，所有治疗组的 AFC 均显著升高。与 Co、Sh、Cb 和 E 组相比，E + Cb 组的 CD25 细胞中位数百分比显著增加。E + Cb 组的 CD5 细胞水平显著高于 Co 组（p = 0.035）。结论：依那西普和/或卡麦角林可减少异位子宫内膜种植体的体积、TNF-α、VEGF 和 CD146/PDGF-Rβ 染色。E 和 E + Cb 治疗可降低卵巢中 TNF-α 水平。E + Cb 还可增加外周血 CD25 和 CD5 细胞。
