CLINICAL AND IMMUNOLOGICAL CHANGES IN TREATMENT OF ADENOMYOSIS IN PATIENTS WITH INFERTILITY

L.Yu. Karakhalis, A. R. Jhigalenko, G. A. Penjhoyan, Н. В. Колесникова
In: Kubanskij nauchnyj medicinskij vestnik · 2017 · pp. 37–44 · doi:10.25207/1608-6228-2017-24-5-37-44 · W2772090279
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study assessed changes in L-selectin, neopterin, and interleukin-6 in adenomyosis patients with infertility and found L-selectin useful for monitoring therapy effectiveness, with gestagens showing better normalization.

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This paper studied 49 infertile women with adenomyosis to determine how adhesion molecules (L-selectin, neopterin, and interleukin-6) change over the course of therapy, using ELISA and assessing adenomyosis symptoms by a VAS scale. The authors formed three groups (two adenomyosis-associated infertility groups and a control group) and found that L-selectin showed statistically significant pre- vs post-treatment differences with a reported correlation coefficient (R=0.584), which they describe as having diagnostic significance for monitoring treatment effectiveness. They report that gestagens were associated with normalization of L-selectin and reduced VAS intensity of dysmenorrhea and dyspareunia compared with another group, while adenomyosis was not accompanied by a substantial increase in neopterin or IL-6 production; the caveat is that the paper focuses on these circulating markers rather than direct tissue or mechanistic measures. Relevance to endometriosis: adenomyosis is explicitly framed within the paper’s immunologic context (with citations about endometriosis and adenomyosis immune-related markers), though the study’s main focus is adenomyois-associated infertility treatment monitoring via adhesion molecules.

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Abstract

Aim . The aim of this study was to asses changes of adhesion molecules (L-selectin, neopterin and interleukin-6) in patients with adenomyosis-related infertility during the therapy. Materials and methods. 49 patients with infertility caused by adenomyosis were examined and divided into 3 clinical groups: 1 group – 26 patients (35,1%) and 2 group – 23 patients (31,1%) with adenomyosis-associated infertility; 3 group (control) – 25 patients (33,8%). Adhesion molecules detection was performed by enzyme immunoassay (EIA). Visual evaluation scale was used for estimating of clinical aspects of adenomyosis. Results. The diagnostic utility of L-selectin for monitoring the adenomyosis therapy effectiveness was shown. The difference between L-selectin levels before and after treatment was statistically significant, the correlation coefficient (R) reached 0,584. The gestagens application is preferable due to reliable normalization of L-selectin levels and decrease in intensity of algomenorrhea (in the 1st group – 1,3 times less, than in 2nd group) and dyspareunia (in the 1st group – 2,2 times less, than in the 2nd group) on visual evaluation scale. Conclusions. Adenomyosis not accompanied by a significant increase in the production of systematic inflammatory response markers (neopterin and IL-6), the increase of adhesion molecules (L-selectin) indicates the imbalance of endothelial-thrombocyte-leukocyte interaction.
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КЛИНИЧЕСКИЕ И ИММУНОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ ПРИ ЛЕЧЕНИИ АДЕНОМИОЗА У ПАЦИЕНТОК С БЕСПЛОДИЕМ https://doi.org/10.25207/1608-6228-2017-24-5-37-44 Аннотация Цель. Определить изменения молекул адгезии (L-селектин, неоптерин и интерлейкин-6) у пациенток с аденомиоз-ассоциированным бесплодием в динамике на фоне терапии. Материалы и методы. Обследовано 49 пациенток с бесплодием на фоне аденомиоза, сформированы 3 клинические группы: 1 группа – 26 пациенток (35,1%) и 2 группа – 23 пациентки (31,1%) с аденомиоз-ассоциированным бесплодием, 3 группа (контрольная) − 25 пациенток (33,8%). Определение молекул адгезии проводили при помощи иммунно-ферментного анализа (ИФА). Оценка клинических проявлений аденомиоза проводилась по визуально аналоговой шкале (ВАШ). Результаты. Показана диагностическая значимость L-cелектина для контроля эффективности терапии аденомиоза. Отличие L-селектина до и после лечения статистически значимо и коэффициент корреляции (R) равен 0,584. Использование гестагенов предпочтительно в связи с достоверной нормализацией L-селектина и снижением интенсивности по ВАШ проявлений альгоменореи: в 1 группе в 1,3 раза меньше, чем во 2-ой и диспареуния: в 1 группе в 2,2 раза меньше, чем во 2-ой. Заключение. Аденомиоз не сопровождается существенным возрастанием продукции маркеров системного воспалительного ответа (неоптерина и ИЛ-6), повышение числа адгезивных молекул (L-селектина) свидетельствует о наличии дисбаланса эндотелиально-тромбоцитарно-лейкоцитарных взаимодействий. Об авторах Л. Ю. КАРАХАЛИСРоссия ул. Седина, д. 4, Краснодар, Россия, 350063 тел.: +7 (861) 222-05-43; +7-988-244-40-44 А. Р. ЖИГАЛЕНКО Россия ул. Седина, д. 4, Краснодар, Россия, 350063 Г. А. ПЕНЖОЯН Россия ул. Седина, д. 4, Краснодар, Россия, 350063 Н. В. КОЛЕСНИКОВА Россия ул. Седина, д. 4, Краснодар, Россия, 350063 Список литературы 1. Devlieger R, D'Hooghe T, Timmerman D. Uterine adenomyosis in the infertility clinic. Hum Reprod Update. 2003; 9: 139-147. 2. Ota H, Igarashi S, Hatazawa J, Tanaka T. Is adenomyosis an immune disease? Hum Reprod Update. 1998; 4: 360-367. 3. Ota H, Igarashi S, Hatazawa J, Tanaka T. Immunohistochemical assessment of superoxide dismutase expression in endometriosis and adenomyosis. Fertil Steril. 1999; 72: 129-134. 4. Ota H, Igarashi S, Kato N, Tanaka T. Aberrant expression of glutathione peroxidase in eutopic and ectopic endometrium in endometriosis and adenomyosis. Fertil Steril. 2000; 74: 313-318. 5. Ota H, Igarashi S, Sasaki M, Tanaka T. Distribution of cyclo-oxygenase-2 in eutopic and ectopic endometrium in endometriosis and adenomyosis. Hum Reprod. 2001; 16: 561-566. 6. Ota H, Igarashi S, Tanaka T. Xanthine oxidase in eutopic and ectopic endometrium in endometriosis and adenomyosis. Fertil Steril. 2001; 75: 785-790. 7. Халафян А.А. STATISTICA 6. Математическая статистика с элементами теории вероятностей. Учебник. М.:БИНОМ. 2010. 496 с. [Halafyan, A.A. STATISTICA 6. Matematicheskaya statistika s elementami teorii veroyatnostei. Uchebnik. M.:BINOM. – 2010: 496. (In Russ.)]. 8. Bird CC, McElin TW, Manalo-Estrella P The elusive adenomyosis of the uterus-revisited. Am J Obstet Gynecol. 1972; 112: 583-593. 9. Barrier BF, Malinowski MJ, Dick EJ Jr, Hubbard GB, Bates GW. Adenomyosis in the baboon is associated with primary infertility. Fertil Steril. 2004; 82: 1091-1094. 10. Lee NC, Dicker RC, Rubin GL, Ory HW. Confirmation of the preoperative diagnoses for hysterectomy. Am J Obstet Gynecol. 1984; 150: 283-287. 11. Карахалис Л.Ю., Жигаленко А.Р. Опыт использования диеногеста 2 мг (Визанны) у пациенток Краснодарского края. Проблемы репродукции. 2012; 5: 41-44. [Karahalis L.Yu., Jhigalenko A.R. Opyt ispol'zovaniya dienogesta 2 mg (Vizany) u patsientok Krasnodarskogo kraya. Problemy reproduktsii. 2012; 5: 41-44. (In Russ.)]. 12. Лапина В.Г., Качалина Т.С., Каткова Н.Ю. Прогностическое значение определения неоптерина и провоспалительных цитокинов в комплексной оценке риска возникновения гестоза. Медицинский альманах. 2010; 4(13): 103-104. [Lapina V.G., Kachalina T.S., Katkova N.Yu. Prognosticheskoe znachenie opredileniya neopterina i provospalitel'nyh tsitokinov v kompleksnoi otsenke riska vozniknoveniya gestoza. Meditsinskii al'manah. 2010; 4(13):103-104 (In Russ.)]. 13. Александрова Е.Н., Новиков А.А., Решетняк Т.М., Попкова Т.В., Клюквина Н.Г., Диатроптова М.А., Черкасова М.В., Денисов Л.Н., Насонов Е.Л. Цитокины и неоптерин при антифосфолипидном синдроме. Научно-практическая ревматология. 2009; 2: 10- 16. [Aleksandrova Е.Н., Novikov А.А., Reschetnyak Т.М., Popkova Т.V., Klyukvina N.G., Diatroptova M.A., Cherkasova M.V., Denisov L.N., Nasonov E.L. Tsitokiny i neopterin pri antifosfolipidnom syndrome. Nauchno-prakticheskaya revmatologiya. 2009; 2:10-16. (In Russ.)]. 14. Bruno C.M., Sciacca C., Cilio D. et al. Circulating adhesion molecules in patients with virus-related chronic diseases of the liver. World. J. Gastroenterol. 2005; 11(29): 4566-4569. Рецензия Для цитирования: КАРАХАЛИС Л.Ю., ЖИГАЛЕНКО А.Р., ПЕНЖОЯН Г.А., КОЛЕСНИКОВА Н.В. КЛИНИЧЕСКИЕ И ИММУНОЛОГИЧЕСКИЕ ИЗМЕНЕНИЯ ПРИ ЛЕЧЕНИИ АДЕНОМИОЗА У ПАЦИЕНТОК С БЕСПЛОДИЕМ. Кубанский научный медицинский вестник. 2017;(5):37-44. https://doi.org/10.25207/1608-6228-2017-24-5-37-44 For citation: KARAKHALIS L.Yu., JHIGALENKO A.R., PENJHOYAN G.A., KOLESNIKOVA N.V. CLINICAL AND IMMUNOLOGICAL CHANGES IN TREATMENT OF ADENOMYOSIS IN PATIENTS WITH INFERTILITY. Kuban Scientific Medical Bulletin. 2017;(5):37-44. (In Russ.) https://doi.org/10.25207/1608-6228-2017-24-5-37-44 JATS XML

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