Circulating Neutrophil Extracellular Traps Are Elevated in Patients With Deep Infiltrating Endometriosis

Jordina Munrós, Munrós J, Tàssies D, Dolors Tàssies, Joan Carles Reverter, Lidia Martín, Lidia Martin, Martin L, A. Rañó Pérez, Pérez A, Amelia Pérez, Francisco Carmona, Maria Ángeles Martínez‐Zamora, María Ángeles Martínez-Zamora, Martínez-Zamora MÁ
Reproductive sciences (Thousand Oaks, Calif.) · 2018 · vol. 26(1) , pp. 70–76 · doi:10.1177/1933719118757682 · PMID:29448896 · W2792308735
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Circulating plasma neutrophil extracellular trap levels were significantly higher in women with endometriosis, particularly those with deep infiltrating endometriosis, compared to controls.

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This preliminary case-control study compared circulating plasma neutrophil extracellular trap (NET) levels, measured as histone-DNA complexes by quantitative sandwich ELISA, between surgically confirmed endometriosis patients (n=82) and controls without surgical evidence of endometriosis (n=35), using venous blood samples collected at the time of surgery. NET levels were significantly higher in the endometriosis group than in controls, and a subgroup analysis showed higher NET levels specifically in patients with deep infiltrating endometriosis (DIE) compared with those without DIE. No differences in NET levels were observed by severe pelvic pain status or infertility status, regardless of the presence of endometriotic lesions. This paper is centrally about endometriosis — it reports elevated circulating NETs in deep infiltrating endometriosis, comparing DIE versus non-DIE within an endometriosis cohort.

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Abstract

Neutrophil extracellular traps (NETs) have been described to be related to the pathogenesis of inflammatory and autoimmune conditions. Endometriosis is currently considered a chronic inflammatory condition. Therefore, we performed a preliminary case-control study to compare the circulating plasma NET levels in patients with surgically confirmed endometriosis (E group, n = 82) and those of patients without surgical findings of endometriosis (C group, n = 35). Venous blood samples were obtained at the time of surgery. Circulating plasma NET levels were assessed as histone-DNA complexes (ie, nucleosomes) by a quantitative sandwich enzyme-linked immunosorbent assay. The results were expressed in arbitrary units. Circulating plasma NET levels were significantly higher in the E group compared with the C group (median [25th; 75th percentiles]): E group: 0.734 [0.484; 1.363]; C group: 0.541 [0.411; 0.653]; P = .005). The subanalysis of E group patients with deep infiltrating endometriosis (DIE group) or without DIE (non-DIE group) showed that plasma NET levels were higher in the DIE group ( P = .02). No differences were observed in NET levels among patients with and without severe pelvic pain or in patients with and without infertility, regardless of the presence of endometriotic lesions. Therefore, our study shows significantly higher NET levels in patients with endometriosis, which seem to be attributed to increased levels in the subgroup of patients with DIE, suggesting that the presence of elevated circulating plasma NET levels may reflect an inflammatory status in this gynecological condition. Further research is warranted to confirm our findings and to assess the exact role of NETs in the pathophysiological mechanisms of endometriosis.
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Abstract

Neutrophil extracellular traps (NETs) have been described to be related to the pathogenesis of inflammatory and autoimmune conditions. Endometriosis is currently considered a chronic inflammatory condition. Therefore, we performed a preliminary case-control study to compare the circulating plasma NET levels in patients with surgically confirmed endometriosis (E group, n = 82) and those of patients without surgical findings of endometriosis (C group, n = 35). Venous blood samples were obtained at the time of surgery. Circulating plasma NET levels were assessed as histone-DNA complexes (ie, nucleosomes) by a quantitative sandwich enzyme-linked immunosorbent assay. The results were expressed in arbitrary units. Circulating plasma NET levels were significantly higher in the E group compared with the C group (median [25th; 75th percentiles]): E group: 0.734 [0.484; 1.363]; C group: 0.541 [0.411; 0.653]; P =.005). The subanalysis of E group patients with deep infiltrating endometriosis (DIE group) or without DIE (non-DIE group) showed that plasma NET levels were higher in the DIE group (P =.02). No differences were observed in NET levels among patients with and without severe pelvic pain or in patients with and without infertility, regardless of the presence of endometriotic lesions. Therefore, our study shows significantly higher NET levels in patients with endometriosis, which seem to be attributed to increased levels in the subgroup of patients with DIE, suggesting that the presence of elevated circulating plasma NET levels may reflect an inflammatory status in this gynecological condition. Further research is warranted to confirm our findings and to assess the exact role of NETs in the pathophysiological mechanisms of endometriosis. Similar content being viewed by others

References

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Condition tags

endometriosisdie_deep_infiltrating

MeSH descriptors

Endometriosis Extracellular Traps Inflammation Adult Case-Control Studies Endometriosis Endometriosis Extracellular Traps Female Humans Inflammation Inflammation Nucleosomes Nucleosomes

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