Korean J Obstet Gynecol.  1999 May;42(5):1030-1034.

Changing Patterns of the Peripheral Blood Cytokine Profile in Women with Endometriosis after GnRH Agonist Treatment

• Choi DS
• Lee JW
• Yoon BK
• Lee JH
• Yang S
• Kim DW
• Kim DH
• Kim JK

Abstract

OBJECTIVE
In endometriosis[ES] patients, changes in immunologic function have been reported. Alterations of immune status resulting from surgery or medical treatment have also been identified. GnRH agonist has been known to have positive modulation effect on nature killer[NK] cell activity and increase the number of NK cell, and upregulation of T-lymphocyte mitogenic activity, but the effect on cytokine has not been delineated. In this study we evaluated the effect of adjuvant GnRH agonist treatment after pelviscopy on the peripheral blood cytokine profile in women with endometriosis.
MATERIALS AND METHODS
Twenty-five patients[ES Stage I-II:12, ES Stage III-IV:13] with endometriosis were studied. All patients were diagnosed under pelviscopy and biopsy specimens were confirmed by a pathologist. Each patient received a total of 4 doses of GnRH agonist at 4-week interval from the next day of pelviscopy. Using ELISA method, peripheral blood cytokine profile[IL-1, IL-2, sIL-2R[soluble interleukin-2 receptor], IL-6, IL-8, MCP[monocyte-chemoattractant protein]-1] were analyzed at the time of pelviscopy, 4 weeks and 12 weeks after pelviscopy. Thirteen patients who underwent gynecologic surgery or pelviscopic surgery with normal pelvis were enrolled as controls.
RESULTS
At the time of pelviscopy there were no significant differences in cytokine profiles except MCP-1 between control and ES patients. After the 1st injection of GnRH agonist[4 weeks after pelviscopy] the peripheral blood IL-1 and IL-6 showed decreasing trend and the MCP-1 showed increasing trend, while sIL-2R and IL-8 showed no difference. Three months after the pelviscopy[after 3 injections of GnRH agonist] the peripheral blood IL-6 and MCP-1 showed consistent decreasing and increasing trend respectively, and there was an increasing trend in IL-1 and IL-8 compared with post-op 1 month of the level. But sIL-2R showed no change. According to ES stage the IL-8 and the MCP-1 showed different response patterns after GnRH agonist treatment.
CONCLUSION
Although there were no significant differences, the peripheral blood cytokines showed different response patterns after GnRH agonist treatment. These changes might have come from the alteration in the function of peripheral blood immune cells after the GnRH agonist treatment.

Keyword

Endometriosis; GnRH agonist; Cytokine profile

MeSH Terms

Biopsy
Cytokines
Endometriosis*
Enzyme-Linked Immunosorbent Assay
Female
Gonadotropin-Releasing Hormone*
Gynecologic Surgical Procedures
Humans
Interleukin-1
Interleukin-2
Interleukin-6
Interleukin-8
Killer Cells, Natural
Pelvis
T-Lymphocytes
Up-Regulation
Cytokines
Gonadotropin-Releasing Hormone
Interleukin-1
Interleukin-2
Interleukin-6
Interleukin-8