The effect of the levonorgestrel-releasing intrauterine system, Mirena® on mast cell numbers in women with endometriosis undergoing symptomatic treatment

Samuel L Engemise, Samuel Engemise, Engemise SL, Willets JM, Jonathon M. Willets, Emembolu JO, J.O. Emembolu, Joseph O Emembolu, Konje JC, Justin C. Konje
European journal of obstetrics, gynecology, and reproductive biology · 2011 · vol. 159(2) , pp. 439–442 · doi:10.1016/j.ejogrb.2011.09.007 · PMID:22018831 · W2081097805
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This study investigated the impact of the levonorgestrel-releasing intrauterine system (Mirena®) on mast cell counts in women with endometriosis experiencing symptomatic relief.

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Abstract

ObjectivesMirena® has been shown to improve symptoms in women with minimal to moderate endometriosis. The precise mechanisms for this have not been thoroughly investigated. We investigate here one possible mechanism-alteration in the number of mast cells in the endometriotic tissue.Study designTissues (endometrial, endometriotic and normal peritoneal biopsies) prospectively collected from twenty-eight women with laparoscopically confirmed minimal to moderate endometriosis before and 6 months after treatment with Mirena® were processed for immunohistochemistry for ER and PR expression followed by toluidine blue staining for mast cells. Photographs were obtained and the receptors and mast cells identified and quantified.ResultsThe mean (± SEM) age of the twenty-eight women was 31 (±7.2) (range 18-42) years. Eight of the endometrial biopsies were in the proliferative phase and twenty in the secretory phase. Six months after Mirena®, the number of mast cell expressed in the tissues decreased significantly in the eutopic (P=0.0358) and ectopic endometrium (P=0.0220) but not in the normal peritoneum (P>0.05). There were no ERs or PRs found in mast cells.ConclusionMirena® causes a reduction in mast cell numbers in ectopic and eutopic endometrium in women undergoing symptomatic treatment of minimal to moderate endometriosis. This reduction could partly explain the efficacy of Mirena® in modulating pain in these women.

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Condition tags

endometriosis

MeSH descriptors

Contraceptive Agents, Female Endometriosis Endometriosis Intrauterine Devices, Medicated Levonorgestrel Mast Cells Adolescent Adult Biopsy Cell Count Contraceptive Agents, Female Contraceptive Agents, Female Endometriosis Endometriosis Endometriosis Endometrium Endometrium Endometrium Endometrium Endometrium

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