Human Reproduction, Vol 13, 1194-1199, Copyright © 1998 by Oxford University Press
HB Zeyneloglu, LM Senturk, E Seli, E Oral, DL Olive and A Arici
Abdomino-pelvic adhesions arise from infection, endometriosis, or
peritoneal injury during surgery, and represent a significant source of
morbidity in women of reproductive age. Monocyte chemotactic protein-1
(MCP-1) plays a role in the chemotaxis of mononuclear cells and fibroblasts
in a murine wound repair model. To evaluate the role of MCP- 1 in
intraperitoneal adhesion formation, we investigated peritoneal fluid MCP-1
levels of women undergoing laparoscopy. Patients without endometriosis were
divided into two groups: normal fertile women undergoing bilateral tubal
ligation without intraperitoneal adhesions (n=14) and women with pelvic
adhesions (n=8). Patients with endometriosis were arranged into two groups:
women with (n=17) and without (n=17) adhesions. Peritoneal fluid MCP-1
levels were quantified using an enzyme-linked immunosorbent assay (ELISA).
Peritoneal biopsy samples were immunostained for the detection of MCP-1
protein and macrophages, and were also processed for the presence of MCP-1
mRNA expression. Among women without endometriosis, the median peritoneal
fluid MCP-1 level was 144 pg/ml (range 54-261) in women without adhesions
and was 336 pg/ml (range 130-2494) in women with adhesions (P=0.01). There
was a significant correlation between adhesion scores and MCP-1 levels
(r=0.50; P=0.018). Among women with endometriosis, peritoneal fluid MCP-1
levels significantly correlated with the stage of the disease. The presence
or absence of adhesions did not significantly affect the peritoneal fluid
MCP-1 levels in this group of women. In summary, we have found that women
with adhesions have elevated peritoneal fluid MCP-1 levels. However, we
were not able to show an incremental effect of adhesions on peritoneal
fluid MCP-1 levels of patients with endometriosis. Thus, we conclude that
factors besides the intraperitoneal adhesions contribute to the elevated
peritoneal fluid MCP-1 levels in patients with endometriosis.
ARTICLES
The role of monocyte chemotactic protein-1 in intraperitoneal adhesion formation
Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06520-8063, USA.
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