Zeyneloglu H B, Senturk L M, Seli E, Oral E, Olive D L, Arici A
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06520-8063, USA.
Hum Reprod. 1998 May;13(5):1194-9. doi: 10.1093/humrep/13.5.1194.
Abdomino-pelvic adhesions arise from infection, endometriosis, or peritoneal injury during surgery, and represent a significant source of morbidity in women of reproductive age. Monocyte chemotactic protein-1 (MCP-1) plays a role in the chemotaxis of mononuclear cells and fibroblasts in a murine wound repair model. To evaluate the role of MCP-1 in intraperitoneal adhesion formation, we investigated peritoneal fluid MCP-1 levels of women undergoing laparoscopy. Patients without endometriosis were divided into two groups: normal fertile women undergoing bilateral tubal ligation without intraperitoneal adhesions (n=14) and women with pelvic adhesions (n=8). Patients with endometriosis were arranged into two groups: women with (n=17) and without (n=17) adhesions. Peritoneal fluid MCP-1 levels were quantified using an enzyme-linked immunosorbent assay (ELISA). Peritoneal biopsy samples were immunostained for the detection of MCP-1 protein and macrophages, and were also processed for the presence of MCP-1 mRNA expression. Among women without endometriosis, the median peritoneal fluid MCP-1 level was 144 pg/ml (range 54-261) in women without adhesions and was 336 pg/ml (range 130-2494) in women with adhesions (P=0.01). There was a significant correlation between adhesion scores and MCP-1 levels (r=0.50; P=0.018). Among women with endometriosis, peritoneal fluid MCP-1 levels significantly correlated with the stage of the disease. The presence or absence of adhesions did not significantly affect the peritoneal fluid MCP-1 levels in this group of women. In summary, we have found that women with adhesions have elevated peritoneal fluid MCP-1 levels. However, we were not able to show an incremental effect of adhesions on peritoneal fluid MCP-1 levels of patients with endometriosis. Thus, we conclude that factors besides the intraperitoneal adhesions contribute to the elevated peritoneal fluid MCP-1 levels in patients with endometriosis.
腹盆腔粘连源于感染、子宫内膜异位症或手术期间的腹膜损伤，是育龄期女性发病的一个重要原因。在小鼠伤口修复模型中，单核细胞趋化蛋白-1（MCP-1）在单核细胞和成纤维细胞的趋化作用中发挥作用。为了评估MCP-1在腹膜粘连形成中的作用，我们研究了接受腹腔镜检查的女性的腹腔液MCP-1水平。无子宫内膜异位症的患者分为两组：行双侧输卵管结扎且无腹腔粘连的正常育龄女性（n = 14）和有盆腔粘连的女性（n = 8）。患有子宫内膜异位症的患者分为两组：有粘连的女性（n = 17）和无粘连的女性（n = 17）。使用酶联免疫吸附测定（ELISA）对腹腔液MCP-1水平进行定量。对腹膜活检样本进行免疫染色以检测MCP-1蛋白和巨噬细胞，并且还对其进行处理以检测MCP-1 mRNA表达。在无子宫内膜异位症的女性中，无粘连女性的腹腔液MCP-1水平中位数为144 pg/ml（范围54 - 261），有粘连女性为336 pg/ml（范围130 - 2494）（P = 0.01）。粘连评分与MCP-1水平之间存在显著相关性（r = 0.50；P = 0.018）。在患有子宫内膜异位症的女性中，腹腔液MCP-1水平与疾病分期显著相关。粘连的有无对该组女性的腹腔液MCP-1水平没有显著影响。总之，我们发现有粘连的女性腹腔液MCP-1水平升高。然而，我们未能显示粘连对子宫内膜异位症患者腹腔液MCP-1水平的增量影响。因此，我们得出结论，除腹腔粘连外的其他因素导致了子宫内膜异位症患者腹腔液MCP-1水平升高。
