Cytokine production in women with different stages of endometriosis

A. A. Grigoryants, И. И. Крукиер, Valeria V. Avrutskaya, М. А. Левкович, O. G. Sarkisian, Eleonora A. Reshetnikova
In: Journal of obstetrics and women's diseases · 2026 · vol. 75(1) , pp. 25–31 · doi:10.17816/jowd643328 · W7154501784
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⚙ AI-generated summary by claude@2026-06, 2026-06-08 ⓘ

This study measured serum and peritoneal fluid cytokine levels in women with endometriosis, finding increased IL-23 in early stages, increased TNF-alpha in advanced stages, and decreased IL-13 in both stages compared to controls.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-12 · read from full text ⓘ

This case-control study evaluated blood serum and peritoneal fluid cytokine levels in reproductive-age women with different stages of endometriosis, comparing stages I–II (n=22) versus stages III–IV (n=25) against apparently healthy controls (n=30). Serum and peritoneal fluid concentrations of TNF-α, TGF-β, IL-13, and IL-23 were measured by ELISA. The authors report that IL-23 was the most markedly altered marker in blood serum for stages I–II (increased 2.65-fold versus controls), whereas TNF-α showed the largest change in peritoneal fluid for stages III–IV (increased 3.2-fold versus controls); IL-13 decreased sharply in both compartments (about 63% lower than controls). A key limitation explicitly stated in the provided text is that the study is limited to young women aged 17–25, which may constrain generalizability. This paper is centrally about endometriosis — it compares systemic (serum) and local (peritoneal fluid) cytokine production across endometriosis stages I–II versus III–IV.

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Abstract

BACKGROUND: Endometriosis is the third most common gynecological disease. The disruption of the cellular and cytokine-mediated mechanisms underlying the course of this pathology remains poorly understood. AIM: The aim of this study was to evaluate blood serum and peritoneal fluid cytokine levels at various stages of endometriosis in women of reproductive age. METHODS: This case-control study included patients aged 17–25 years who were diagnosed with endometriosis stages I–II (Group I) and stages III–IV (Group II). The comparison group included apparently healthy women. Blood serum and peritoneal fluid levels of tumor necrosis factor-alpha, transforming growth factor-beta, and interleukins IL-13 and IL-23 were determined by enzyme-linked immunosorbent assay using reagents manufactured in the USA. RESULTS: The study included 77 women. Group I consisted of 22 patients, and Group II of 25 patients. The comparison group comprised 30 apparently healthy women. The most significant changes in the blood serum of patients in Group I were observed in IL-23 level, which was increased by 2.65 times compared to the comparison group. In patients in Group II with endometriosis stages III–IV, the most significant changes in the peritoneal fluid were observed in tumor necrosis factor-alpha level, which was increased by 3.2 times compared to the comparison group. In contrast, IL-13 level dropped sharply in both peritoneal fluid and blood serum (on average, by 63% compared to the comparison group). CONCLUSION: The identified general patterns and characteristics of regulatory responses in endometriosis expand our understanding of the mechanisms of disease development and treatment prospects.
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Abstract

BACKGROUND: Endometriosis is the third most common gynecological disease. The disruption of the cellular and cytokine-mediated mechanisms underlying the course of this pathology remains poorly understood. AIM: The aim of this study was to evaluate blood serum and peritoneal fluid cytokine levels at various stages of endometriosis in women of reproductive age.

Methods

This case-control study included patients aged 17–25 years who were diagnosed with endometriosis stages I–II (Group I) and stages III–IV (Group II). The comparison group included apparently healthy women. Blood serum and peritoneal fluid levels of tumor necrosis factor-alpha, transforming growth factor-beta, and interleukins IL-13 and IL-23 were determined by enzyme-linked immunosorbent assay using reagents manufactured in the USA.

Results

The study included 77 women. Group I consisted of 22 patients, and Group II of 25 patients. The comparison group comprised 30 apparently healthy women. The most significant changes in the blood serum of patients in Group I were observed in IL-23 level, which was increased by 2.65 times compared to the comparison group. In patients in Group II with endometriosis stages III–IV, the most significant changes in the peritoneal fluid were observed in tumor necrosis factor-alpha level, which was increased by 3.2 times compared to the comparison group. In contrast, IL-13 level dropped sharply in both peritoneal fluid and blood serum (on average, by 63% compared to the comparison group).

Conclusion

The identified general patterns and characteristics of regulatory responses in endometriosis expand our understanding of the mechanisms of disease development and treatment prospects. Full Text About the authors Armen A. Grigoryants Stavropol State Medical University Author for correspondence. Email: [email protected] ORCID iD: 0000-0002-9333-2578 SPIN-code: 6945-4464 MD, Cand. Sci. (Medicine), Assistant Professor Russian Federation, StavropolIrina I. Krukier Rostov State Medical University Email: [email protected] ORCID iD: 0000-0003-4570-6405 SPIN-code: 4975-1350 Dr. Sci. (Biology) Russian Federation, Rostov-on-DonValeria V. Avrutskaya Rostov State Medical University Email: [email protected] ORCID iD: 0000-0001-6399-5007 SPIN-code: 9495-9702 MD, Dr. Sci. (Medicine), Professor Rostov-on-DonMarina А. Levkovich Rostov State Medical University Email: [email protected] ORCID iD: 0000-0001-8047-7148 SPIN-code: 2964-0480 MD, Dr. Sci. (Medicine), Assistant Professor Russian Federation, Rostov-on-DonOleg G. Sarkisyan Rostov State Medical University Email: [email protected] ORCID iD: 0000-0001-5293-986X SPIN-code: 9938-5822 MD, Dr. Sci. (Medicine), Professor Russian Federation, Rostov-on-DonEleonora A. Reshetnikova Rostov State Medical University Email: [email protected] ORCID iD: 0009-0008-7422-0221 SPIN-code: 2646-6673 Cand. Sci. (Biology), Assistant Professor Russian Federation, Rostov-on-DonReferences - Adamyan LV, Andreeva EN. Endometriosis and its global impact on a woman’s body. Russian Journal of Human Reproduction. 2022;28(1):54–64. doi: 10.17116/repro20222801154 EDN: ELOTDZ - Coxon L, Horne AW, Vincent K. Pathophysiology of endometriosis-associated pain: a review of pelvic and central nervous system mechanisms. Best Pract Res Clin Obstet Gynaecol. 2018;51:53–67. doi: 10.1016/j.bpobgyn.2018.01.014 EDN: YHCFPN - Maddern J, Grundy L, Castro J, et al. Pain in endometriosis. Front Cell Neurosci. 2020;14:590823. doi: 10.3389/fncel.2020.590823 EDN: ZHVWBI - Horne AW, Missmer SA. Pathophysiology diagnosis and management of endometriosis. BMJ. 2022;379:e070750. doi: 10.1136/bmj-2022-0707504 - Zondervan KT, Becker CM, Missmer SA Endometriosis. N Engl J Med. 2020;382(13):1244–1256. doi: 10.1056/NEJMra18107645 EDN: VHNBSA - Grigoryants AA, Burova NA, Avrutskaya VV, et al. Severity of pelvic pain syndrome associated with external genital endometriosis in women of reproductive age as a prognostic factor of the degree of prevalence of the process. Bulletin of the Volgograd State Medical University. 2024;21(2):157–162. doi: 10.19163/1994-9480-2024-21-2-157162 EDN: AMDJVP - Tsitskarava DZ, Yarmolinskaya MI, Selyutin AV, et al. Evaluation of the content and pathogenetic role of peritoneal fluid cytokines in patients with deep infiltrating endometriosis. Journal of Obstetrics and Women’s Diseases. 2017;66(1):38–45. doi: 10.17816/JOWD66138-45 EDN: XWVGDT - Zhou WJ, Yang HL, Shao J, et al. Anti-inflammatory cytokines in endometriosis. Cell Mol Life Sci. 2019;76(11):2111–2132. doi: 10.1007/s00018-019-03056-x EDN: WWNTNN - Levkovich MA, Ermolova NV, Krukier II, et al. Features of cytokine production at the systemic and local level in patients of reproductive age with external genital endometriosis. Medical Herald of the South of Russia. 2023;14(4):5–10. doi: 10.21886/2219-8075-2023-14-4-5-10 EDN: WOBPYQ - Kinnunen K, Piippo N, Loukovaara S, et al. Lysosomal destabilization activates the NLRP3 inflammasome in human umbilical vein endothelial cells (HUVECs). J Cell Commun Signal. 2017;11(3):275–279. doi: 10.1007/s12079-017-0396-4 EDN: IUFXKB - Sourial S, Tempest N, Hapangama DK. Theories on the рathogenesis of endometriosis. Int J Reprod Med. 2014;2014:179515. doi: 10.1155/2014/17915

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