Influence of progestin use on the IL-10 level in peritoneal endometriosis

endometriosis, peritoneum, cytokines, IL-10, progestinAbstract Purpose: How can progestin influence the anti-inflammatory cytokine IL-10 level in the peritoneum with endometriosis? Methods: A cross-sectional study with a laboratory analysis carried out in tertiary hospitals in southern Brazil with clinical-demographic data compilation and sample collection of peritoneal lavage and a peritoneum biopsy from 40 patients — 22 with endometriosis (11 with progestin and 11 without it) and 18 in the control group — was conducted. For the sample analysis, the ELISA was performed, and a comparison of the average IL-10 concentrations by ANOVA followed by Bonferroni was carried out. Results: There was a higher concentration of IL-10 among patients with endometriosis compared to the control group (p ≤ 0.05), and statistical significance was observed with a reduction of IL-10 in the peritoneal lavage of patients with endometriosis in the use of progestin (8.1 ± 7.4 pg/ml) compared to those with endometriosis without using progestin (17.9 ± 10.5 pg/ml). Considering the disease stage, a higher level of IL-10 (p ≤ 0.05) was observed both in the initial stages (12.1 ± 10.5 pg/ml) and in advanced stages (15.4 ± 9.7 pg/ml) compared to the control (1.7 ± 1.8 pg/ml), which was significantly higher for advanced endometriosis. Downloads

Bulun SE (2009) Endometriosis Mechanisms of disease. N Engl J Med. 360:268-79. https://doi.org/10.1056/NEJMra0804690. Fuldeore MJ, Soliman AM (2017) Prevalence and symptomatic burden of diagnosed endometriosis in the United States: national estimates from a cross-sectional survey of 59,411 women. Gynecol and Obstet Invest. 82(5):453-61. https://doi.org/10.1159/000452660. Ahn SH, Monsanto SP, Miller C, Singh SS, Thomas R, Tayade C (2015) Pathophysiology and immune dysfunction in endometriosis. Biomed Res Int. 2015:1-12. https://doi.org/10.1155/2015/795976. Hickey M, Ballard K, Farquhar C. Endometriosis (2014) BMJ. 348:g1752. https://doi.org/10.1136/bmj.g1752. Johnson NP, Hummelshoj L, Adamson GD, Keckstein J, Taylor HS, Abrao MS, et al (2017) World Endometriosis Society Sao Paulo Consortium. World Endometriosis Society consensus on the classification of endometriosis. Hum Reprod. 32(2):315-24. https://doi.org/10.1093/humrep/dew293. Audebert A, Petousis S, Margioula-Siarkou C, Ravanos K, Prapas N, Prapas Y(2018) Anatomic distribution of endometriosis: a reappraisal based on series of 1101 patients. Eur J Obstet Gynecol Reprod Biol. 230:36-40. https://doi.org/10.1016/j.ejogrb.2018.09.001. Barra F, Grandi G, Tantari M, Scala C, Facchinetti F, Ferrero S (2019) A comprehensive review of hormonal and biological therapies for endometriosis: latest developments. Expert Opin Biol Ther. 19(4):343-60. https://doi.org/10.1080/14712598.2019.1581761. Andres MP, Borrelli GM, Abrão MS (2018) Endometriosis classification according to pain symptoms: can the ASRM classification be improved? Best Pract Res Clin Obstet Gynaecol. 51:111-8. https://doi.org/10.1016/j.bpobgyn.2018.06.003. Burney, RO, Giudice, LC (2012) Pathogenesis and pathophysiology of endometriosis. Fertil Steril. 98(3):511-9. https://doi.org/10.1016/j.fertnstert.2012.06.029. Gueuvoghlanian-Silva BY, Hernandes C, Correia RP, Podgaec S. (2020) Deep infiltrating endometriosis and activation and memory surface markers and cytokine expression in isolated Treg cells. Reprod Sci. 27(2):599-610. https://doi.org/10.1007/s43032-019-00060-1. Riccio LDGC, Santulli P, Marcellin L, Abrão MS, Batteux F, Chapron C (2018) Immunology of endometriosis. Best Pract Res Clin Obstet Gynaecol. 50:39-49. https://doi.org/10.1016/j.bpobgyn.2018.01.010. Malutan AM, Drugan T, Ciortea R, Mocan-Hognogi RF, Bucuri C, Rada MP, et al (2015) Serum anti-inflammatory cytokines for the evaluation of inflammatory status in endometriosis. J Res Med Sci. 20(7):668-74. https://doi.org/10.4103/1735-1995.166215. Börner C, Scheerer C, Buschow R, Chiantera V, Sehouli J, Mechsner S (2017) Pain mechanisms in peritoneal diseases might be partially regulated by estrogen. Reprod Sci. 25(3):424-34. https://doi.org/10.1177/1933719117715126. Tokushige N, Markham R, Russell P, Fraser IS (2009) Effect of progestogens and combined oral contraceptives on nerve fibers in peritoneal endometriosis. Fertil Steril. 92(4):1234-9. https://doi.org/10.1016/j.fertnstert.2008.07.1774. Halme J, Hammond MG, Hulka JF, Raj SG, Talbert LM (1984) Retrograde menstruation in healthy women and in patients with endometriosis. Obstet Gynecol. 64(2):151-4. Vinatier D, Orazi G, Cosson M, Dufour P (2001) Theories of endometriosis. Eur J Obstet Gynecol Reprod Biol. 96(1):21-34. https://doi.org/10.1016/s0301-2115(00)00405-x. Patel BG, Rudnicki M, Yu J, Shu Y, Taylor RN (2017) Progesterone resistance in endometriosis: origins, consequences, and interventions. Acta Obstet Gynecol Scand. 96(6):623-32. https://doi.org/10.1111/aogs.13156. Ahn SH, Singh V, Tayade C (2017) Biomarkers in endometriosis: challenges and opportunities. Fertil Steril. 107(3):523-32. https://doi.org/10.1016/j.fertnstert.2017.01.009. Mancini F, Milardi D, Carfagna P, Grande G, Miranda V, De Cicco Nardone A, et al (2018) Low-dose SKA Progesterone and Interleukin-10 modulate the inflammatory pathway in endometriotic cell lines. Int Immunopharmacol. 55:223-230. https://doi.org/10.1016/j.intimp.2017.12.008. Bellelis P, Barbeiro DF, Gueuvoghlanian-Silva BY, Kalil J, Abrão MS, Podgaec S (2019) Interleukin-15 and Interleukin-7 are the major cytokines to maintain endometriosis. Gynecol Obstet Invest. 84(5):435-44. https://doi.org/10.1159/000496607. Suen JL, Chang Y, Shiu YS, Hsu CY, Sharma P, Chiu CC (2019) IL-10 from plasmacytoid dendritic cells promotes angiogenesis in the early stage of endometriosis. J Pathol. 249(4):485-97. https://doi.org/10.1002/path.5339. Jiang J, Jiang Z, Xue M (2019) Serum and peritoneal fluid levels of interleukin-6 and interleukin-37 as biomarkers for endometriosis. Gynecol Endocrinol. 35(7):571-5. https://doi.org/10.1080/09513590.2018.1554034. Sikora J, Smycz-Kubańska M, Mielczarek-Palacz A, Bednarek I, Kondera-Anasz Z (2018) The involvement of multifunctional TGF-β and related cytokines in pathogenesis of endometriosis. Immunol Lett. 201:31-7. https://doi.org/10.1016/j.imlet.2018.10.011. Gallagher JS, DiVasta AD, Vitonis AF, Sarda V, Laufer MR, Missmer SA (2018) The impact of endometriosis on quality of life in adolescents. J Adolesc Health. 63:766-72. https://doi.org/10.1016/j.jadohealth.2018.06.027. Vercellini P, Buggio L, Berlanda N, Barbara G, Somigliana E, Bosari S (2016) Estrogen-progestins and progestins for the management of endometriosis. Fertil Steril. 106(7):1552-71. http://dx.doi.org/10.1016/j.fertnstert.2016.10.022 Barra F, Scala C, Ferrero S (2018) Current understanding on pharmacokinetics, clinical efficacy, and safety of progestins for treating pain associated to endometriosis. Expert Opin Drug Metab Toxicol. 14(4):399-415. https://doi.org/10.1080/17425255.2018.1461840. Grandi G, Mueller MD, Papadia A, et al (2016) inflammation influences steroid hormone receptors targeted by progestins in endometrial stromal cells from women with endometriosis. J Reprod Immunol. 117:30‐8. https://doi.org/10.1016/j.jri.2016.06.004. Vigo F, Lubianca JN, Corleta HE. (2011) Progestógenos: farmacologia e uso clínico. Femina. 39(3):127-37. Schoep ME, Nieboer TE, van der Zanden M, Braat DDM, Nap AW (2019) The impact of menstrual symptoms on everyday life: a survey among 42,879 women. Am J Obstet Gynecol. 220(6):569.e1‐569.e7. https://doi.org/10.1016/j.ajog.2019.02.048. Paula R Jr, Oliani AH, Vaz-Oliani DC, D’Ávila SC, Oliani SM, Gil CD (2015) The intricate role of mast cell proteases and the annexin A1-FPR1 system in abdominal wall endometriosis. J Mol Histol. 46(1):33-43. https://doi.org/10.1007/s10735-014-9595-y Volpato LK, Horewicz VV, Bobinski F, Martins DF, Piovezan AP (2018) Annexin A1, FPR2/ALX, and inflammatory cytokine expression in peritoneal endometriosis. J Reprod Immunol. 129:30-5. https://doi.org/10.1016/j.jri.2018.08.002. Barra F, Scala C, Maggiore ULR, Ferrero S (2020) Long-term administration of Dienogest for the treatment of pain and intestinal symptoms in patients with rectosigmoid endometriosis. J Clin Med. 9(1):154. https://doi.org/10.3390/jcm9010154. Margatho D, Carvalho NM, Bahamondes L (2020) Endometriosis-associated pain scores and biomarkers in users of the etonogestrel-releasing subdermal implant or the 52-mg levonorgestrel-releasing intrauterine system for up to 24 months. Eur J Contracept Reprod Health Care 25(2):133-140. https://doi.org/10.1080/13625187.2020.1725461. Vignali M, Belloni GM, Pietropaolo G, Di Prun AB, Barbera V, Angioni S, et al (2020) Effect of Dienogest therapy on the size of the endometrioma. Gynecol Endocrinol. 1-5. https://doi.org/10.1080/09513590.2020.1725965. Cho B, Roh JW, Park J, Jeong K, Kim TH, Kim YS, et al (2020) Safety and effectiveness of Dienogest (Visanne®) for treatment of endometriosis: a large prospective cohort study. Reprod Sci. 27(3):905-15. https://doi.org/10.1007/s43032-019-00094-5. Nanda A, K T, Banerjee P, Dutta M, Wangdi T, Sharma P (2020) Cytokines, angiogenesis, and extracellular matrix degradation are augmented by oxidative stress in endometriosis. Ann Lab Med. 40(5):390-7. https://doi.org/10.3343/alm.2020.40.5.390. Published How to Cite Issue Section Copyright (c) 2022 International journal of health sciences This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. Articles published in the International Journal of Health Sciences (IJHS) are available under Creative Commons Attribution Non-Commercial No Derivatives Licence (CC BY-NC-ND 4.0). Authors retain copyright in their work and grant IJHS right of first publication under CC BY-NC-ND 4.0. 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