L26/P-373 Pro- and anti-inflammatory status of patients with endometriosis depending on disease severity

Abstract Study question What is the impact of pro-inflammatory cytokines and their receptors on the severity and susceptibility to endometriosis? Summary answer Altered levels some of the tested factors are associated with endometriosis progression and its susceptibility to disease. What is known already The precise mechanisms underlying origin and development of endometriosis remain mainly unknown. Mechanisms of attachment, growth and disease severity have been difficult to elucidate due to the complex nature of the disease; however, it is now well-established that endometriosis is a chronic inflammatory condition. Pro-inflammatory cytokines play a critical role in generating and also progression of endometriosis by promoting survival, growth, invasion, differentiation, angiogenesis, and immune evasion. Study design, size, duration Women with endometriosis were confirmed by laparoscopy. Control women had no medical history of endometriosis and pelvic inflammation or other immune-related diseases. The severity of the disease was determined on the basis of the current recommendations of the American Society for Reproductive Medicine (ASRM) and the Polish Gynecological Society. Research is being conducted since 2022 to the present. Participants/materials, setting, methods We tested a total of 213 women. The concentration of 13 analytes - cytokines (IFN-ɣ, IL-1β, IL-2, IL-4, IL-6, IL-10, IL-12p70, IL-17A, TNF-α), VEGF-A and their receptors VEGF-R1, VEGF-R2, TNF-R1 were measured in plasma from 134 patients and 79 controls and peritoneal fluid from 134 patients and 50 controls. For this purpose we used multianalyte profiling on a Luminex 200 device. Main results and the role of chance We found a significant differences in the concentrations of the analytes between blood plasma and peritoneal fluid. Statistical higher levels of IL-1β, IL-2, IL-4, IL-12p70, IL-17A, TNF-α were observed in the blood plasma, whereas the IL-6, IL-10, TNF-R1, VEGF-A, VEGF-R2 were more concentrated in the peritoneal fluid. We observed higher concentration in peritoneal fluid of IL-1β and IL-6 in the patients group with moderate and severe stage of endometriosis (III+IV) compared to healthy women (p = 0.0064, p = 0.0006, respectively). Moreover, concentration of IL-6 in peritoneal fluid of patients with more advanced stages (III and IV) was higher than in patients with minimal endometriosis (stage I) (p = 0.0046, p = 0.0001, respectively). Lower level of receptor VEGF-R2 in peritoneal fluid have been associated with minimal and mild endometriosis (I and II) compared to stage III (p = 0.05, p = 0.03, respectively). Limitations, reasons for caution The limitation of this study was the small number of patients examined, especially when divided into groups according to disease severity. Wider implications of the findings Understanding all aspects and manifestations of the disease, both in peripheral blood and at the affected site, can help improve treatment and thereby alleviate disease effects. This study is part of a broader project, where the pro- and anti-inflammatory profiles of the patients studied are also important. Trial registration number No