Shafrir Amy L, Laliberte Ashley, Wallace Britani, Vitonis Allison F, Sieberg Christine B, Ghiasi Marzieh, Magpantay Larry I, Epeldegui Marta, Schrepf Andrew, As-Sanie Sawsan, Terry Kathryn L, Missmer Stacey A
Department of Health Sciences and Nutrition, School of Nursing and Health Sciences, Merrimack College, North Andover, MA 01845, USA.
Division of Adolescent and Young Adult Medicine, Department of Pediatrics, Boston Children's Hospital and Harvard Medical School, Boston, MA 02115, USA.
Int J Mol Sci. 2025 Jun 4;26(11):5377. doi: 10.3390/ijms26115377.
We evaluated inflammatory markers among 389 surgically confirmed endometriosis cases and 505 controls from the Women's Health Study: From Adolescence to Adulthood (A2A) cohort. Participants reported dysmenorrhea, acyclic pelvic pain, dyspareunia, and pain with bowel movements. Using multiplex assays, we measured their levels of plasma interleukin (IL)-1β, -6, -8, -10, and -16, tumor necrosis factor (TNF)-α, monocyte chemotactic protein (MCP)-1 and -4, thymus and activation-regulated chemokine (TARC), and interferon gamma-induced protein (IP)-10. For each symptom, we computed biomarker-level geometric means (GMs) with 95% confidence intervals (95% CI) using multivariate linear regression among the endometriosis cases and controls, with interactions with case/control status tested using Wald statistics. Among the controls, those with dyspareunia had lower levels of IL-8 (GM = 4.64 [95% CI = 4.41-4.89] pg/mL vs. GM = 4.99 [95% CI = 4.82-5.17] pg/mL; = 0.02), and the IL-8 levels were lower for controls reporting pain with bowel movements (GM = 4.66 [95% CI = 4.43-4.89] vs. GM = 4.96 [95% CI = 4.82-5.11] pg/mL, = 0.03). No significant associations between pelvic pain symptoms and inflammatory markers were observed among the endometriosis cases; however, the relationship between inflammatory marker levels and pain experience varied by analgesic use at blood draw. Dyspareunia and pain with bowel movements were associated with inflammatory markers among the controls, while the associations between pelvic pain symptoms and inflammatory markers among the endometriosis cases differed by analgesic use.
我们在来自“从青春期到成年期女性健康研究”（A2A）队列的389例经手术确诊的子宫内膜异位症病例和505例对照中评估了炎症标志物。参与者报告了痛经、非周期性盆腔疼痛、性交困难以及排便时疼痛情况。我们采用多重检测法测量了她们血浆中白细胞介素（IL）-1β、-6、-8、-10和-16、肿瘤坏死因子（TNF）-α、单核细胞趋化蛋白（MCP）-1和-4、胸腺和活化调节趋化因子（TARC）以及干扰素γ诱导蛋白（IP）-10的水平。对于每种症状，我们在子宫内膜异位症病例和对照中使用多变量线性回归计算生物标志物水平的几何均数（GMs）及其95%置信区间（95%CI），并使用Wald统计量检验与病例/对照状态的相互作用。在对照中，有性交困难的女性IL-8水平较低（GM = 4.64 [95%CI = 4.41 - 4.89] pg/mL，而GM = 4.99 [95%CI = 4.82 - 5.17] pg/mL；P = 0.02），报告排便时疼痛的对照者IL-8水平也较低（GM = 4.66 [95%CI = 4.43 - 4.89] vs. GM = 4.96 [95%CI = 4.82 - 5.11] pg/mL，P = 0.03）。在子宫内膜异位症病例中未观察到盆腔疼痛症状与炎症标志物之间存在显著关联；然而，炎症标志物水平与疼痛体验之间的关系因采血时是否使用镇痛药而异。性交困难和排便时疼痛与对照中的炎症标志物相关，而子宫内膜异位症病例中盆腔疼痛症状与炎症标志物之间的关联因镇痛药使用情况而有所不同。
