title: A tumor necrosis factor-α inhibitor reduces the embryotoxic effects of endometriotic peritoneal fluid.
abstract: OBJECTIVE
  To determine whether a tumor necrosis factor-α (TNF-α) inhibitor can reduce the embryotoxicity of the peritoneal fluid (PF) of women with endometriosis.
  
  
  METHODS
  Experimental clinical study.
  
  
  METHODS
  University hospital.
  
  
  METHODS
  Twelve women with chocolate cysts and 12 control women without endometriosis.
  
  
  METHODS
  None.
  
  
  METHODS
  We collected the PF from patients with chocolate cysts (CH-PF) and patients without endometriosis (N-PF) during laparoscopic surgery. For the in vitro studies, development and apoptosis were evaluated in two-cell stage mouse embryos after incubation with CH-PF and N-PF, with or without a TNF-α inhibitor.
  
  
  RESULTS
  We found that CH-PF significantly decreased the rate of blastocyst development and increased the percentage of apoptotic cells in the embryos. Cytokine assays showed that the concentrations of several cytokines, including TNF-α, were higher in embryos incubated with CH-PF than in those incubated with N-PF. Furthermore, the treatment of embryos with TNF-α retarded development and induced apoptosis. Important, adalimumab, a TNF-α inhibitor, effectively abrogated the embryotoxicity that was induced by CH-PF.
  
  
  CONCLUSIONS
  These data collectively highlight the crucial role of TNF-α in CH-PF-induced embryotoxicity and suggest that TNF-α inhibitors may be potential therapeutic agents for treating endometriosis-induced infertility.
authors.affiliation: Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan; Division of Obstetrics and Gynecology, Faculty of Medicine, School of Medicine, National Yang-Ming University, Taipei, Taiwan.
authors.forename: Yi-Jen
authors.initials: YJ
authors.lastname: Chen
authors.forename: Hua-Hsi
authors.initials: HH
authors.lastname: Wu
authors.forename: Wan-Ting
authors.initials: WT
authors.lastname: Liau
authors.forename: Chang-Youh
authors.initials: CY
authors.lastname: Tsai
authors.forename: Hsiao-Wen
authors.initials: HW
authors.lastname: Tsai
authors.forename: Kuan-Chong
authors.initials: KC
authors.lastname: Chao
authors.forename: Yen-Jen
authors.initials: YJ
authors.lastname: Sung
authors.forename: Hsin-Yang
authors.initials: HY
authors.lastname: Li
mesh_terms: D000068879:Adalimumab; D000328:Adult; D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000494:pharmacology*; D017209:Apoptosis / Q000187:drug effects; D001202:Ascitic Fluid / Q000276:immunology*; D001755:Blastocyst / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D016022:Case-Control Studies; D046149:Embryo Culture Techniques; D047108:Embryonic Development / Q000187:drug effects; D004715:Endometriosis / Q000150:complications / Q000276:immunology*; D005260:Female; D006801:Humans; D007247:Infertility, Female / Q000188:drug therapy / Q000276:immunology / Q000473:pathology; D051379:Mice; D010048:Ovarian Cysts / Q000150:complications / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000378:metabolism; D015854:Up-Regulation
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D014409:Tumor Necrosis Factor-alpha; D000068879:Adalimumab
keywords: TNF-α; embryotoxicity; endometriosis; peritoneal fluid