Pro-inflammatory Cytokines (IL6, IL8 and TNF-a) in the Evaluation of Ovarian Endometriosis Cyst
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This study correlated pro-inflammatory cytokines TNF-a, IL-6, and IL-8 with intraoperative laparoscopic findings in 39 endometriosis patients.
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This study evaluated pro-inflammatory cytokines IL-6, IL-8, and TNF-α in serum from 39 patients diagnosed with ovarian endometriosis cyst, with preoperative assessment and repeat sampling 6 months after surgery, and compared results to a control group of 26 cases without confirmed endometriosis. Serum IL-6 and IL-8 levels were significantly increased in the endometriosis group versus controls, while TNF-α was reported as insignificantly low (p=0.072). The authors note non-normal distribution for IL-6 and IL-8 in both groups (Shapiro-Wilk tests), and used Mann-Whitney tests accordingly, but the work provides limited detail on symptom/correlation analyses and relies on a relatively small sample. This paper is centrally about endometriosis — it specifically measures IL-6, IL-8, and TNF-α as biomarkers in ovarian endometriosis cyst.
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Abstract
Endometriosis is the abnormal growth of cells (endometrial cells) similar to those that form the inside of the uterus, but in a location outside of the uterus. Endometriosis is most commonly found on other organs of the pelvis. These lesions are most commonly found on the ovaries, the Fallopian tubes, the surface of the uterus, the bowel, and on the membrane lining of the pelvic cavity (i.e. the peritoneum). We corroborate TNF-a, IL-6 and IL-8 markers with intraoperative laparoscopic on 39 patients diagnosed with endometriosis in January 2016 - December 2017, aged 20-45 years. There has been a preoperative evaluation in the patients from this that included the anamnesis, clinical examination and laboratory tests. Anamnesis recorded demographic details, patient�s personal, physiological and pathological medical history. Evaluation of preoperative investigations consisted of general and local systems examination, a gynecological examination in order to identify the specific signs of endometriosis. Making matters worse is that endometriosis exhibits significant immunological dysfunction, including the over-expression of pro-inflammatory cytokines like interleukin-1 (IL-1), interleukin-6 (IL-6), and tumor necrosis factor (TNF), all of which contribute to a chronic up-regulation of painful, tissue-damaging inflammatory processes. Because the cause of endometriosis is poorly understood, there are no known ways to prevent its development.
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Material and methods
In our study group of 39 patients diagnosed with ovarian
endometriosis cyst, the dosage of immunological markers
and cytokine IL-6, IL-8 and TNF- α levels in serum was
performed preoperatively and 6 months after surgery. We
compared marker values for patients diagnosed with
endometriosis with those of a control group (26 cases) to
whom this diagnosis was not confirmed. The data was
processed using SPSS v17 statistical package software.
REV .CHIM.(Bucharest)♦70♦No. 8 ♦2019 http://www.revistadechimie.ro 2945
The numerical variables were compared with the
nonparametric Mann-Whitney U test (in the case of two
independent groups). For p<0.05 were considered
statistical significance [7-8].
Results
and discussion s
Endometriosis is a polygenic disease with a complex,
multifactorial ethology that affects approximately 10% of
reproductive-age women. Women with endometriosis
have symptoms that include chronic pelvic pain,
dysmenorrhea and dyspareunia, that significantly reduce
the quality of their life [9-10]. Endometriosis is also the
main cause of infertility in women, the prevalence rate
ranging from 20 to 50% [11-12].
In order to describe the IL - 6, IL - 8 and TNF values we
calculated the central tendency and dispersion parameters
and we plotted the recommended figures (tables 1-3,
figures 1- 4).
Table 1
VALUES OF CENTRAL AND DISPERSION TREND INDICATORS FOR THE IL-6
VARIABLE
Fig. 1. The normal Q-Q plots for the IL - 6 values
IL-6 values for the patients in the study
group do not follow a normal distribution
(Shapiro-Wilk normality test, p = 0.038).
IL-6 values for patients in the control group
do not follow a normal distribution
(Shapiro-Wilk normality test, p <0.001).Table 2
VALUES OF CENTRAL AND DISPERSION TREND INDICATORS FOR THE
TNF VARIABLE
TNF values for patients in the control
group follow a normal distribution
(Shapiro-Wilk normality test, p = 0.239).
TNF values for the patients in the study
group follow a normal distribution
(Shapiro-Wilk normality test, p = 0.815).
Fig. 2. The normal Q-Q plots for
the TNF values
http://www.revistadechimie.ro REV .CHIM.(Bucharest)♦70♦ No. 8 ♦20192946
Table 3
VALUES OF CENTRAL AND DISPERSION TREND
INDICATORS FOR THE IL-8 VARIABLE
Fig. 3.The normal Q-Q plots
for the IL - 8 values
IL-8 values for patients in the control group do
not follow a normal distribution (Shapiro-Wilk
normality test, p < 0.001)
IL-8 values for the patients in the study
group do not follow a normal distribution
(Shapiro-Wilk normality test, p < 0.001)
Fig. 4. The histogram and the
Box plot for the I - 6, TNF and
IL - 8
The histograms of IL-6 values compared to the
two samples
Box Plot representation of IL-6 values
compared to the two samples
The Histograms of TNF values compared to the two
samples
Box Plot representation of TNF values
compared to the two samples
Fig.5
REV .CHIM.(Bucharest)♦70♦No. 8 ♦2019 http://www.revistadechimie.ro 2947
IL-6 values are significantly increased for the study group
compared to control (Mann-Whitney U Test, p = 0.001).
TNF values for the endometriosis group are
insignificantly low (Unpaired t Test, p=0.072) (fig.5).
IL-8 values are significantly increased for the study group
compared to control (Mann-Whitney U Test, p < 0.001)
(fig. 6).
Conclusions
Pro-inflammatory cytokines appear to play an important
role in the development of endometriosis, initially acting
locally and then manifesting systemically, thus rendering
the clinical picture of endometriosis. The high prevalence
and severe consequences of this disease caused ta major
public health issue in modern society. And yet, the
mechanism responsible for the initiation and development
of this disease still remains an enigma.
Identifying a non-invasive diagnostic marker for
endometriosis could facilitate the early diagnosis of this
pathology and early medical management with an
appropriate treatment for each case.
References
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Fig.6
The Histograms of IL-8 values compared to the
two samples
Box Plot representation of IL-8 values
compared to the two samples
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Manuscript received:17.01.2019
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References (6)
- Endometriosis Does Not Confer Improved Prognosis in Ovarian Carcinoma of Uniform Cell Type via openalex
- Mini-laparoscopic surgery versus conventional laparoscopic surgery for patients with endometriosis via openalex
- Non-invasive diagnosis of endometriosis based on a combined analysis of six plasma biomarkers via openalex
- Risk factors associated with endometriosis among infertile Iranian women via openalex
- Suppression of COUP-TFII by Proinflammatory Cytokines Contributes to the Pathogenesis of Endometriosis via openalex
- W1992451410 via openalex
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