Evaluation of Estradiol and Pro-Inflammatory Marker Level with VAS Score After Progestin Therapy in Endometriosis Patients

Aidrus Muthalib, Asha Murshida Muthalib, Kanadi Sumapraja, Achmad Kemal Harzif, Mila Maidarti
In: Indonesian Journal of Obstetrics and Gynecology · 2024 · pp. 237–243 · doi:10.32771/inajog.v12i4.2531 · W4404939700
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This cross-sectional study of endometriosis patients found that COX-2 levels were significantly higher in those experiencing pain after progestin therapy and correlated with VAS scores, while IL-1beta and IL-6 showed significant positive correlation.

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This observational cross-sectional study evaluated serum levels of estradiol and pro-inflammatory biomarkers, including IL-6, IL-1B, and COX-2, in 47 endometriosis patients undergoing three months of progestin therapy. The researchers compared these biochemical markers between patients who reported pain and those who did not, utilizing ELISA methods for measurement and visual analog scale scores to assess pain intensity. Results indicated that patients experiencing pain had significantly higher COX-2 levels than those without pain, while COX-2 also showed a weak but significant positive correlation with VAS pain scores. This paper is centrally about endometriosis — specifically examining the relationship between inflammatory markers, pain status, and progestin treatment outcomes in affected patients.

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Abstract

Objectives: To compare estradiol levels and proinflammatory biomarkers (IL-6, IL-1B, and COX-2) in endometriosis patients with pain and without pain after progestin therapy. Methods: This observational cross-sectional study involved 47 endometriosis patients undergoing three months of progestin therapy at RSUPN Cipto Mangunkusumo from March to June 2024. Serum levels of COX-2, IL-6, IL-1B, and estradiol will be measured using ELISA and Microplate Enzyme Immunoassay, with pain status assessed to determine associations between biomarkers and pain presence. Results: A significant difference in COX-2 levels between patients with pain and those without, with higher levels in the pain group [1.845 (1.24-10.26) vs 1.55 (0.32-3.07), p = 0.004]. A significant positive correlation was found between IL-1Beta and IL-6 (r = 0.471, p = 0.001). COX-2 levels also exhibited a weak but statistically significant positive correlation with VAS scores (r = 0.360, p = 0.013). Conclusion: There is a difference in inflammatory markers IL-6, IL-1 Beta and COX-2 in endometriosis patients with progestin therapy who experience pain and painlessness. Keywords: endometriosis, estradiol, proinflammation, progestin therapy.
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Objectives

To compare estradiol levels and proinflammatory biomarkers (IL-6, IL-1B, and COX-2) in endometriosis patients with pain and without pain after progestin therapy.

Methods

This observational cross-sectional study involved 47 endometriosis patients undergoing three months of progestin therapy at RSUPN Cipto Mangunkusumo from March to June 2024. Serum levels of COX-2, IL-6, IL-1B, and estradiol will be measured using ELISA and Microplate Enzyme Immunoassay, with pain status assessed to determine associations between biomarkers and pain presence.

Results

A significant difference in COX-2 levels between patients with pain and those without, with higher levels in the pain group [1.845 (1.24-10.26) vs 1.55 (0.32-3.07), p = 0.004]. A significant positive correlation was found between IL-1Beta and IL-6 (r = 0.471, p = 0.001). COX-2 levels also exhibited a weak but statistically significant positive correlation with VAS scores (r = 0.360, p = 0.013).

Conclusion

There is a difference in inflammatory markers IL-6, IL-1 Beta and COX-2 in endometriosis patients with progestin therapy who experience pain and painlessness.

Keywords

endometriosis, estradiol, proinflammation, progestin therapy.

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Outcome instruments

VAS-pain

Condition tags

endometriosis

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