The role of cytokines in the clinical presentation of external genital endometriosis and chronic pelvic pain

The role of cytokines in the clinical presentation of external genital endometriosis and chronic pelvic pain L.V.Adamyan / M.M.Sonova / K.N.Arslanyan / О.N.Loginova / Objective. To study the role of cytokines in the clinical presentation of external genital endometriosis and chronic pelvic pain. Patients and methods. We examined 260 patients with histologically verified diagnosis of external genital endometriosis (EGE), who were treated in hospital settings during the period from 2015 to 2018. Two groups were singled out: group 1 (n = 156) – patients who did not have pain syndrome and group 2 (n = 104) – women who had pain syndrome for not less than 6 months. Enzyme-linked immunosorbent assay (ELISA) was used to examine neuroangiogenesis factors (BDNF, NGF, VEGF), oncomarker (СА-125), and adhesion molecules (sIСАМ-1). Blood serum and peritoneal fluid were the material for immunological examinations. Results. We have found a statistically significant increase of the average concentrations of cytokines VEGF, СА-125, sICAM-1 in endometriosis groups at local and systemic levels as compared with the group without endometriosis. We have also found a significant (р = 0.006) strong (r(s) = 0.79) correlation between an EGE stage and chronic pelvic pain (CPP) scoring >7 on the VAS rating scale and serum СА-125 concentrations. A significant correlation have been found between serum СА-125 levels and a positive response (≥19 scores) on the Pain Detect scale. In endometriosis, along with higher levels of proinflammatory cytokines, an increase in neuroangiogenesis factors (BDNF, NGF, VEGF) was also observed, and these levels showed statistically significant changes depending on the presence of pain. Association between endometriosis and CPP and statistically significant levels of such neurocytokines as BDNF, NGF confirms their important contribution to the pathogenesis of pain in this disease. Conclusion. Cytokines, along with other clinical parameters, might serve as an important tool for monitoring treatment of patients with EGE. Key words: external genital endometriosis, neurotrophins, nerve growth factor, chronic pelvic pain, cytokines. For citation: Adamyan L.V., Sonova M.M., Arslanyan K.N., Loginova О.N. The role of cytokines in the clinical presentation of external genital endometriosis and chronic pelvic pain. Vopr. ginekol. akus. perinatol. (Gynecology, Obstetrics and Perinatology). 2020; 19(1): 5–11. (In Russian). DOI: 10.20953/1726-1678-2020-1-5-11 Open access