The clinical effectiveness and pathogenetic mechanisms of using human recombinant interferon alpha-2b in combined treatment of patients with external genital endometriosis

E.I. Durneva, Maria I. Yarmolinskaya, Д. И. Соколов, S. А. Selkov, A. V. Selyutin
In: Voprosy ginekologii, akušerstva i perinatologii · 2018 · vol. 18(2) , pp. 61–68 · doi:10.20953/1726-1678-2019-2-61-68 · W2965693110
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Combined therapy with interferon alpha-2b and GnRHa for external genital endometriosis showed greater clinical efficacy and altered cytokine profiles compared to GnRHa monotherapy.

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This study evaluated the clinical effectiveness and pathogenetic mechanisms of adding human recombinant interferon alpha-2b to gonadotropin-releasing hormone agonist therapy in 46 patients with histologically confirmed external genital endometriosis. Researchers compared outcomes between a group receiving combined treatment and a control group receiving GnRHa monotherapy, measuring cytokine levels in peripheral blood and peritoneal fluid before and after six months of intervention. The results indicated that the addition of interferon led to greater clinical efficacy and more pronounced modulation of inflammatory markers, specifically decreasing RANTES and increasing MCP-1, which suggests enhanced inhibition of neoangiogenesis and inflammation. This paper is centrally about endometriosis — specifically the use of immunomodulatory agents in treating external genital lesions.

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Gynecology, Obstetrics and Perinatology - Gynecology, Obstetrics and Perinatology - 2019 volume 18 issue 2 The clinical effectiveness and pathogenetic mechanisms of using human recombinant interferon alpha-2b in combined treatment of patients with external genital endometriosis Authors / Institutions E.I.Durneva / Maria I. Yarmolinskaya / D.I.Sokolov / Sergey A. Selkov / A.V.Selutin / The objective. Assessment of the clinical effectiveness and pathogenetic mechanisms of administration of human recombinant interferon alpha-2b (IFNα-2b) in combined treatment of patients with external genital endometriosis (EGE). Patients and methods. We examined 46 patients aged 21 до 43 years with a histologically confirmed diagnosis of EGE (stage I and II according to the R-AFS classification ), among which 21 patients (treatment group) received standard therapy with gonadotropin-releasing hormone agonists (GnRHa) for 6 months in combination with IFNα-2b, and 25 patients (comparison group) – GnRHa monotherapy for 6 months. Also, the control group was singled out (20 women), in whom no gynaecological pathology was found intraoperatively. Before operative intervention and 6 months after treatment started, the pain syndrome was assessed. The levels of IL-8, IP-10, TNF-α, MCP-1, RANTES were determined in peripheral blood (PB) and peritoneal fluid (PF). Results. Patients with EGE had a characteristic increase of PF concentrations of IL-8, TNF-α, MCP-1, RANTES and decreased levels of IP-10. Combined treatment with the use of IFNα-2b demonstrated a more marked decrease of RANTES and increase of MCP-1 in PB, as well as a greater clinical efficacy than in the comparison group. Conclusion. The impact of IFNα-2b on the cytokine profile as part of combined EGE therapy is indicative of a more intense inhibition of neoangiogenesis and inflammation compared to GnRHa therapy, therefore, its administration is pathogenetically justified. Key words: interferon, cytokines, endometriosis. For citation: Durneva E.I., Yarmolinskaya M.I., Sokolov D.I., Sel’kov S.A., Selyutin A.V. The clinical effectiveness and pathogenetic mechanisms of using human recombinant interferon alpha-2b in combined treatment of patients with external genital endometriosis. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2019; 18(2): 61–68. (In Russian). DOI: 10.20953/1726-1678-2019-2-61-68 Patients and methods. We examined 46 patients aged 21 до 43 years with a histologically confirmed diagnosis of EGE (stage I and II according to the R-AFS classification ), among which 21 patients (treatment group) received standard therapy with gonadotropin-releasing hormone agonists (GnRHa) for 6 months in combination with IFNα-2b, and 25 patients (comparison group) – GnRHa monotherapy for 6 months. Also, the control group was singled out (20 women), in whom no gynaecological pathology was found intraoperatively. Before operative intervention and 6 months after treatment started, the pain syndrome was assessed. The levels of IL-8, IP-10, TNF-α, MCP-1, RANTES were determined in peripheral blood (PB) and peritoneal fluid (PF). Results. Patients with EGE had a characteristic increase of PF concentrations of IL-8, TNF-α, MCP-1, RANTES and decreased levels of IP-10. Combined treatment with the use of IFNα-2b demonstrated a more marked decrease of RANTES and increase of MCP-1 in PB, as well as a greater clinical efficacy than in the comparison group. Conclusion. The impact of IFNα-2b on the cytokine profile as part of combined EGE therapy is indicative of a more intense inhibition of neoangiogenesis and inflammation compared to GnRHa therapy, therefore, its administration is pathogenetically justified. Key words: interferon, cytokines, endometriosis. For citation: Durneva E.I., Yarmolinskaya M.I., Sokolov D.I., Sel’kov S.A., Selyutin A.V. The clinical effectiveness and pathogenetic mechanisms of using human recombinant interferon alpha-2b in combined treatment of patients with external genital endometriosis. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2019; 18(2): 61–68. (In Russian). DOI: 10.20953/1726-1678-2019-2-61-68

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