Enhanced interleukin-4 expression in patients with endometriosis.

OBJECTIVE

To investigate the expression of cytokines by T-helper cells type 1 (interleukin [IL]-2 and interferon-gamma [IFN-gamma]) and type 2 (IL-4 and IL-10) in peripheral blood monocytes and peritoneal fluid (PF) cells from patients with endometriosis.

DESIGN

Peripheral blood (PB) monocytes and PF cells from patients with endometriosis were isolated and the expression of cytokines investigated.

SETTING

Institute for the treatment of endometriosis and research institute in university-based medical center.

PATIENT(S): The study included 7 women with normal pelvic structure, 36 patients with endometriosis, and 7 women with pelvic adhesion but without apparent endometriotic lesion. The existence and severity of endometriosis was determined by laparoscopic examination.

INTERVENTION(S): All patients received laparoscopic operation to identify the existence and stages of endometriosis. Danazol (200 mg, twice daily) was prescribed for those with endometriosis.

MAIN OUTCOME MEASURE(S): Transcription of cytokines were directly analyzed using the reverse transcriptase-polymerase chain reaction method. The concentrations of cytokines in peritoneal fluids and sera were analyzed by the ELISA.

RESULT(S): Levels of IL-4 messenger RNA (mRNA) and protein in the PB and peritoneal cells of patients with endometriosis were higher than those of normal patients, whereas levels of IFN-gamma mRNA and protein were suppressed. There were no significant changes in the mRNA or protein levels of IL-2 or IL-10 in both peritoneal fluids and sera. The level of IL-4 was reduced to normal after combined treatment with laparoscopic surgery and danazol. The secretion of IFN-gamma was elevated after treatment.

CONCLUSION(S): Cytokine secretion by T-helper cells type 1 and type 2 is altered in women with endometriosis, suggesting that these T-helper subsets play a role in the immunologic responses to endometriosis.