The Relationship Between The Concentration Of MCP-1 In Peritoneal Fluid And Ectopic Endometrial Tissue Of Women With Endometriosis And Disease Development

IntroductionEndometriosis is a common benign gynecologic condition characterized by metastasis and implantation of endometrial - like tissue mainly in the peritoneal cavity of patients, but its pathogenesis remains unclear. More and more scholars believe that host immunologi-cal dysfunction has been invoked as a causal factor in the development of endometriosis and it may be a cause of pain and reduced fertility in some patients. One of the most consistently reported immunological abnormalities is that of monocyte activation and recruitment into peritoneal cavity of patients. Activated monocytes/macrophages are known to secrete many growth factors and other cytokines, which may promote the growth of endometrial explants and numerous proinflammatory molecules that may exacerbate the inflammatory reaction observed in the peritoneal cavity of endometriosis patients.Monocyte chemotactic protein - 1 ( MCP - 1) is a chemokine of which the major biological property known to date is that of peripheral blood monocyte activation and recruitment into the peritoneal cavity , the results of which are elevated concentrations and biological activity of monocyte in peritoneal cavity. As shown in some researches, elevated concentration of MCP - 1 both in peritoneal fluid and the ectopic endometrium is found in patients with endometriosis. But it remainscontroversial whether the expression of MCP -1 in situ could vary with the stages of the disease. Therefore, the objective of the present study was to examine the in situ concentrations of MCP - 1 in the endometri-um and peritoneal fluid of women with and without endometriosis by ELISA and to investigate whether the level of MCP - 1 could vary with the stage of the disease and whether the severity of dysmenorrhea could vary with the stage of the disease. We expected to provide theoretical-basis for novel therapy and monitoring indicators. Furthermore, there is to date no relative report at home and abroad about examination of concentration of MCP - 1 in tissue in vivo by this method.Materials and MethodsSubjects Ectopic endometrial specimens used in the study were obtained from twenty - seven women and peritoneal fluid specimens were from twenty - six women with endometriosis diagnosed during laparoscopy or laparotomy in the present study . The severity of the endometriosis was determined according to the revised American Fertility Society, in the group of peritoneal fluid, stage 1 and 2 ( early stages) = 8 patients, stage 3 and 4 ( more advanced stages) = 18 patients; in the group of endomertium specimens, stage 1 and 2 ( early stages) = 9 patients, stage 3 and 4 (more advanced stages) =18 patients. Moreover , the severity of the dysomenorrhea (including 0,1,2,3) was determined according to the standard of dysmenorrhea score. The peritoneal fluid of control subjects ( n = 9 ) were collected form fertile women requesting reanastomosis of tubes, having no visible evidence of endometriosis and inflammation at laparoscopy. Endometrial tissues in control group ( n = 9) were collected form fertile women with uterinemyoma who showed a normal pelvic peritoneum at laparotomy. There is no significant difference between the age of endometriosis cases and control cases.Collection and Processing of samples The peritoneal fluid was aspirated during laparoscpy and lapartomy. Immediately after collection, the samples were centrifuged at 3000 rpm for 10 min at 4 C , and the supernatants were aliquoted and stored at -86t until analyzed. En-do metrial biopsies were obtained during operation. After douche of saline , the specimens were immediately transported to the laboratory and stored at - 86C until assayed.MCP - 1 sandwich ELISA The tissue specimens were made into homogenate (10% ) . The concentration of MCP - 1 in peritoneal fluid and ectopic endometrium were measured using the Sandwich ELISA, following the established procedure of test kit. The samples of peritoneal fluid were diluted five times.Statistical Analyses Comparison of concentration was performed using stu...