Cytokine profiles and metabolic dysregulation in endometriosis: insights into diagnostic and therapeutic targets.

INTRODUCTION: Endometriosis is a chronic inflammatory disorder marked by the ectopic growth of endometrial-like tissue, affecting 10–15% of women of reproductive age. Pro-inflammatory cytokines (TNF-α, IL-1β, IL-6) drive inflammation and disease progression, while anti-inflammatory cytokines (TGF-β, IL-10) maintain immune balance. Metabolic markers like homocysteine, folic acid, and vitamin B12 may influence immune regulation and contribute to endometriosis pathophysiology. METHODOLOGY: Serum levels of TNF-α, IL-1β, IL-6, IL-10, TGF-β, CRP, Ferritin, IL-4, IFN-γ, Homocysteine, Folic Acid, and Vitamin B12 were quantified using ELISA kits. Unpaired t-tests and Pearson correlation were used to assess immune-metabolic differences between endometriosis patients and healthy controls. RESULTS: TNFα, IL-6, IL-1β, IL-10, homocysteine, ferritin, and reduced IFN-γ and CRP levels in the case group compared to controls (p < 0.05). TNFα (p = 0.0008), IL-1β (p = 0.0005), and homocysteine (p < 0.0001) were notably higher in cases. IFN-γ (p < 0.0001) and CRP (p < 0.0001) were significantly lower in cases. IL-6 (p = 0.0020), IL-10 (p = 0.0051), ferritin (p = 0.0338), and folate (p = 0.0134) also showed significant differences. TGF-β, IL-4, and Vit-B12 levels did not differ significantly (p > 0.05). These findings suggest altered cytokine and biochemical profiles in disease pathophysiology. CONCLUSION: The study highlights significant alterations in inflammatory cytokines and metabolic markers in endometriosis patients compared to healthy controls. Elevated pro-inflammatory and altered anti-inflammatory cytokine levels, along with metabolic imbalance, suggest immune-metabolic dysregulation in disease pathogenesis. These findings may aid in identifying potential biomarkers and therapeutic targets for endometriosis.