Tóth Norbert, Brubel Réka, Bokor Attila, Kemény Ágnes, Farkas Nelli, Pál Tibor, Helyes Zsuzsanna, Pohóczky Krisztina
Department of Pharmacology and Pharmacotherapy, Medical School, University of Pécs, 7624 Pécs, Hungary.
1st Department of Obstetrics and Gynecology, Semmelweis University, 1082 Budapest, Hungary.
Int J Mol Sci. 2025 Jul 12;26(14):6695. doi: 10.3390/ijms26146695.
Endometriosis is the extrauterine engraftment of endometrium-like tissue, causing chronic pain. Complex sensory-vascular-immune interactions, including growth factors, cytokines, and neuropeptides, are implicated in its pathophysiology, but the mechanisms remain unknown. Here, epidermal growth factor (EGF), vascular endothelial growth factor, interleukins (IL-1β, IL-6, IL-8), macrophage migration inhibitory factor (MIF), calcitonin gene-related peptide, and somatostatin were measured in the serum of endometriosis patients with different disease severities, menstruation cycle- and pharmacotherapy-related hormonal status compared with controls. Mediator levels in deep-infiltrating rectosigmoid nodules were also compared with those in non-endometriotic colon tissues. Pain was assessed by the visual analogue scale. Serum EGF was significantly lower in mild endometriosis and in the secretory phase. MIF and IL-6 were higher in stage I-IV endometriosis, with MIF also higher in the secretory phase and in patients not receiving oral contraceptives. Somatostatin was lower in mild endometriosis than that in healthy individuals and the severe endometriosis group. No tissue-level differences were found. A strong positive correlation between serum EGF and somatostatin levels and dysmenorrhea and dysuria was detected in mild cases. It is concluded that certain serum alterations may be related to severity- and hormone status-dependent endometriosis mechanisms, but their diagnostic/prognostic value seems to be limited due to variability and lack of specificity.
子宫内膜异位症是子宫内膜样组织在子宫外的植入，可导致慢性疼痛。复杂的感觉-血管-免疫相互作用，包括生长因子、细胞因子和神经肽，与其病理生理学有关，但其机制尚不清楚。在此，对不同疾病严重程度、月经周期和药物治疗相关激素状态的子宫内膜异位症患者血清中的表皮生长因子（EGF）、血管内皮生长因子、白细胞介素（IL-1β、IL-6、IL-8）、巨噬细胞移动抑制因子（MIF）、降钙素基因相关肽和生长抑素进行了检测，并与对照组进行比较。还比较了直肠乙状结肠深部浸润结节中的介质水平与非子宫内膜异位症结肠组织中的介质水平。通过视觉模拟评分法评估疼痛。轻度子宫内膜异位症患者及分泌期血清EGF显著降低。MIF和IL-6在I-IV期子宫内膜异位症患者中较高，MIF在分泌期及未服用口服避孕药的患者中也较高。轻度子宫内膜异位症患者的生长抑素低于健康个体和重度子宫内膜异位症组。未发现组织水平差异。在轻度病例中，血清EGF和生长抑素水平与痛经和排尿困难之间存在强正相关。结论是，某些血清改变可能与子宫内膜异位症的严重程度和激素状态依赖性机制有关，但由于其变异性和缺乏特异性，它们的诊断/预后价值似乎有限。
