Evaluation of serum and peritoneal fluid mannose-binding lectin associated serine protease-3, adipsin, properdin, and complement factor-H levels in endometriosis patients

Merve Didem Eşkin Tanrıverdi, Ecem Kaya‐Sezginer, Esin Koç, Özlem Moraloğlu Tekın
International Journal of Gynecology & Obstetrics · 2025 · vol. 170(1) , pp. 174–181 · doi:10.1002/ijgo.16195 · PMID:39907303 · W4407176228
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⚙ AI-generated summary by gemini-2.5-flash-lite, 2026-06-07 ⓘ

Serum adipsin and complement factor-H levels were elevated in women with endometriosis and correlated with disease markers, suggesting a role for these alternative complement pathway molecules in the condition.

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⚙ AI-generated deep summary by qwen3.7-flash, 2026-08-20 · read from full text ⓘ

This prospective study compared serum and peritoneal fluid levels of alternative complement system molecules, including adipsin, properdin, mannose-binding lectin-associated serine protease-3, and complement factor-H, in 32 women with laparoscopically confirmed endometriosis versus 26 healthy controls. The results indicated that serum levels of adipsin and complement factor-H were significantly elevated in the endometriosis group, with adipsin showing positive correlations with CA-125 levels and pelvic pain severity. Additionally, a strong positive correlation was observed between peritoneal fluid concentrations of adipsin and complement factor-H. This paper is centrally about endometriosis, specifically investigating the role of the alternative complement pathway in its pathogenesis through biomarker analysis.

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Abstract

OBJECTIVE: Endometriosis is a chronic disease which has been reported to be associated with distorted immune mechanisms. The alternative pathway is a complement system which plays a role in immune defense. The present study aimed to evaluate whether the level of alternative complement molecules differ in women with endometriosis compared to heathy individuals. METHODS: A total of 58 women participated in this prospective research. Women with a diagnosis of endometriosis confirmed by laparoscopy (n = 32) were compared to healthy women (n = 26) in terms of serum adipsin, properdin, mannose-binding lectin-associated serine protease-3 and complement factor-H (CFH) levels. The peritoneal fluid samples which were taken during the endometriosis surgery were also analyzed in terms of the complement levels. The clinical and demographic data including the serum CA-125 level and pelvic pain were also analyzed. SPSS version 23.0 was used in statistical analysis. RESULTS: The serum levels of adipsin and CFH were found to be significantly increased in women with endometriosis (P = 0.027 and P = 0.040, respectively). Serum adipsin level was found to significantly correlate with serum CA-125 level (r = 0.320, P = 0.015), serum CFH level (r = 0.705, P < 0.001), and degree of the pelvic pain complaint (r = 0.326, P = 0.013). A strong, positive correlation was also observed between peritoneal fluid levels of adipsin, and CFH (r = 0.593; P < 0.001). CONCLUSION: To the best of our knowledge, the present study is the first to evaluate the alternative complement system in women with endometriosis. The current findings may be noteworthy to elucidate the possible role of the key molecules of the alternative pathway in endometriosis pathogenesis.
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Abstract

Objective Endometriosis is a chronic disease which has been reported to be associated with distorted immune mechanisms. The alternative pathway is a complement system which plays a role in immune defense. The present study aimed to evaluate whether the level of alternative complement molecules differ in women with endometriosis compared to heathy individuals.

Methods

A total of 58 women participated in this prospective research. Women with a diagnosis of endometriosis confirmed by laparoscopy (n = 32) were compared to healthy women (n = 26) in terms of serum adipsin, properdin, mannose-binding lectin-associated serine protease-3 and complement factor-H (CFH) levels. The peritoneal fluid samples which were taken during the endometriosis surgery were also analyzed in terms of the complement levels. The clinical and demographic data including the serum CA-125 level and pelvic pain were also analyzed. SPSS version 23.0 was used in statistical analysis.

Results

The serum levels of adipsin and CFH were found to be significantly increased in women with endometriosis (P = 0.027 and P = 0.040, respectively). Serum adipsin level was found to significantly correlate with serum CA-125 level (r = 0.320, P = 0.015), serum CFH level (r = 0.705, P < 0.001), and degree of the pelvic pain complaint (r = 0.326, P = 0.013). A strong, positive correlation was also observed between peritoneal fluid levels of adipsin, and CFH (r = 0.593; P < 0.001).

Conclusion

To the best of our knowledge, the present study is the first to evaluate the alternative complement system in women with endometriosis. The current findings may be noteworthy to elucidate the possible role of the key molecules of the alternative pathway in endometriosis pathogenesis. CONFLICT OF INTEREST STATEMENT The authors declare no conflicts of interest. DATA AVAILABILITY STATEMENT The research data are available to share by request to the editorial board.

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Condition tags

endometriosis

MeSH descriptors

Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid Ascitic Fluid

Citation neighborhood

Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

References (30)

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