Pellicer A, Albert C, Mercader A, Bonilla-Musoles F, Remohí J, Simón C
Instituto Valenciano de Infertilidad, Department of Pediatrics, Obstetrics and Gynecology, Valencia University School of Medicine, Spain.
Fertil Steril. 1998 Sep;70(3):425-31. doi: 10.1016/s0015-0282(98)00204-0.
To assess the endocrine, paracrine, and autocrine milieu in patients with endometriosis on the basis of the measurement of several cytokines in serum and follicular fluid (FF) and in vitro culture of granulosa luteal cells.
Case-control study.
In vitro fertilization program at the Instituto Valenciano de Infertilidad.
PATIENT(S): Twenty patients with laparoscopically documented endometriosis and 18 controls. Fifteen subjects were studied in a natural cycle and 23 were investigated in a stimulated cycle while undergoing IVF.
INTERVENTION(S): Individual follicle aspiration, oocyte isolation, FF storage, and preparation of luteinized granulosa cell cultures. Diagnostic laparoscopy in natural cycles.
MAIN OUTCOME MEASURE(S): Serum (day of ovum pick-up or laparoscopy) and FF measurement of interleukin (IL)-1beta, IL-6, and vascular endothelial growth factor (VEGF). Secretion of IL-1beta, IL-6, and VEGF in the cell-conditioned medium. Results were compared between patients with endometriosis and controls.
RESULT(S): Interleukin-6 levels in serum were increased in the natural cycles of patients with endometriosis and modulated by ovarian stimulation, showing a significant decrease in hMG- and FSH-stimulated cycles and a significant increase after hCG administration. In addition, IL-6 levels were increased in the FF of patients with endometriosis and released in higher amounts by their granulosa luteal cells. Vascular endothelial growth factor was accumulated in lesser concentrations in the FF of patients with endometriosis. Interleukin-1beta levels did not show significant changes. Implantation rates were decreased significantly in patients with endometriosis who were undergoing IVF.
CONCLUSION(S): The data demonstrate that cytokines are regulated differently in patients with endometriosis, who have increased IL-6 production, and suggest that fine hormonal modulation of this cytokine occurs at the systemic and local (ovarian) levels. These changes show that the endocrine, paracrine, and autocrine milieu is different in patients with endometriosis and may be related to their lower implantation rates.
通过检测血清和卵泡液（FF）中的多种细胞因子以及对颗粒黄体细胞进行体外培养，评估子宫内膜异位症患者的内分泌、旁分泌和自分泌环境。
病例对照研究。
瓦伦西亚不育症研究所的体外受精项目。
20例经腹腔镜证实患有子宫内膜异位症的患者和18例对照者。15名受试者在自然周期中接受研究，23名在接受体外受精的促排卵周期中接受调查。
单个卵泡抽吸、卵母细胞分离、FF储存以及黄体化颗粒细胞培养物的制备。自然周期中的诊断性腹腔镜检查。
血清（取卵日或腹腔镜检查日）和FF中白细胞介素（IL）-1β、IL-6和血管内皮生长因子（VEGF）的测量。细胞条件培养基中IL-1β、IL-6和VEGF的分泌。比较子宫内膜异位症患者和对照者的结果。
子宫内膜异位症患者自然周期血清中的白细胞介素-6水平升高，并受卵巢刺激调节，在人绝经期促性腺激素（hMG）和促卵泡激素（FSH）刺激的周期中显著降低，在注射人绒毛膜促性腺激素（hCG）后显著升高。此外，子宫内膜异位症患者FF中的IL-6水平升高，且其颗粒黄体细胞释放的量更多。血管内皮生长因子在子宫内膜异位症患者的FF中积累浓度较低。白细胞介素-1β水平未显示出显著变化。接受体外受精的子宫内膜异位症患者的着床率显著降低。
数据表明，子宫内膜异位症患者体内细胞因子的调节方式不同，IL-6产生增加，提示该细胞因子在全身和局部（卵巢）水平受到精细的激素调节。这些变化表明，子宫内膜异位症患者的内分泌、旁分泌和自分泌环境不同，可能与其较低的着床率有关。
