Elevated levels of interleukin-6 in ascites and serum from women with ovarian hyperstimulation syndrome.
OBJECTIVE
To examine the role of pro-inflammatory cytokines in ovarian hyperstimulation syndrome (OHSS).


METHODS
In vitro laboratory study of serum, peritoneal cells isolated and fluid obtained from ascites removed in the therapeutic management of four patients with OHSS.


METHODS
Tertiary care referral teaching hospital.


METHODS
Four patients with OHSS comprised the study population. Five healthy women at the time of elective laparoscopic tubal ligation served as controls. Control serum was also obtained from healthy adult volunteers, and control peritoneal fluid (PF) was obtained from patients on peritoneal dialysis.


METHODS
Therapeutic paracentesis was performed on four patients with OHSS.


RESULTS
Peritoneal cells were isolated and fluid obtained from ascites removed in the therapeutic management of the women with OHSS. Peritoneal cells were obtained by intraoperative lavage from the control women. The cells were incubated with various concentrations of Escherichia coli lipopolysaccharide (LPS) for 20 and 48 hours. Interleukin-1 beta (IL-1 beta), tumor necrosis factor (TNF), interleukin-6 (IL-6), and prostaglandin E2 (PGE2) were assayed in the incubation supernatants. The release of the three cytokines and PGE2 in response to LPS by peritoneal cells from women with OHSS was not different from the controls. However, both serum and ascitic fluid from women with OHSS contained significantly greater levels of IL-6 than control serum and PF. No significant differences in TNF levels in serum, ascitic fluid, or PF could be found by ELISA or bioassay.


CONCLUSIONS
Increased production of IL-6, released into the peritoneal cavity and the circulation, may mediate OHSS.
Friedlander
M A
MA
Department of Medicine, University Hospitals of Cleveland, Ohio 44106.
Loret de Mola
J R
JR
Goldfarb
J M
JM
D000328:Adult; D001201:Ascites / Q000378:metabolism*; D015415:Biomarkers / Q000032:analysis / Q000097:blood; D003613:Danazol / Q000627:therapeutic use; D004715:Endometriosis / Q000097:blood / Q000188:drug therapy / Q000378:metabolism; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000097:blood / Q000378:metabolism; D015850:Interleukin-6 / Q000032:analysis* / Q000097:blood; D016471:Ovarian Hyperstimulation Syndrome / Q000097:blood / Q000378:metabolism*
D015415:Biomarkers; D015850:Interleukin-6; D003613:Danazol