title: Interleukin-6, interleukin-1β, and tumor necrosis factor α in menstrual effluents as biomarkers of chronic endometritis.
abstract: OBJECTIVE
  To assess the relationship between chronic endometritis (CE) and proinflammatory cytokine levels in menstrual effluents and to develop a simple noninvasive test for screening CE.
  
  
  METHODS
  Case-control study.
  
  
  METHODS
  Academic center.
  
  
  METHODS
  Sixty-four women referred to our center for infertility.
  
  
  METHODS
  Office hysteroscopy; endometrial biopsy; collection of menstrual blood at subsequent cycle.
  
  
  METHODS
  Interleukin (IL) 6, IL-1β, and tumor necrosis factor (TNF) α concentrations in menstrual effluents.
  
  
  RESULTS
  Thirty-six out of 64 infertile women had histologically proven CE. The remaining 28 women were included as controls. IL-6, IL-1β, and TNF-α levels were markedly higher in menstrual effluents of women with CE compared with control subjects. Receiver operating characteristic curve analysis revealed a good CE screening capacity for all of the cytokines. The combined evaluation of either IL-6/TNF-α or IL-6/IL-1β increased the diagnostic capacity of the test, which reached a 100% sensitivity and a negative predictive value of 100 when at least one cytokine was found to exceed its cutoff value; it also reached a 100% specificity and a positive predictive value of 100 in cases of positivity of both cytokines. Logistic regression analysis confirmed the IL-6/TNF-α-based model as a significant predictor of CE.
  
  
  CONCLUSIONS
  Proinflammatory cytokine levels are increased in menstrual effluents of women with CE. A test dosing IL-6 and TNF-α seems to have a high screening capacity for CE.
authors: Dipartimento Interdisciplinare di Medicina, University of Bari, Bari, Italy.
authors: Cosimo
authors: C
authors: Tortorella
authors: Dipartimento Interdisciplinare di Medicina, University of Bari, Bari, Italy.
authors: Giuseppina
authors: G
authors: Piazzolla
authors: Dipartimento di Scienze Biomediche ed Oncologia Umana, University of Bari, Bari, Italy.
authors: Maria
authors: M
authors: Matteo
authors: Dipartimento di Scienze Biomediche ed Oncologia Umana, University of Bari, Bari, Italy.
authors: Vincenzo
authors: V
authors: Pinto
authors: Dipartimento di Scienze Biomediche ed Oncologia Umana, University of Bari, Bari, Italy.
authors: Raffaele
authors: R
authors: Tinelli
authors: Dipartimento Interdisciplinare di Medicina, University of Bari, Bari, Italy.
authors: Carlo
authors: C
authors: Sabbà
authors: Dipartimento Interdisciplinare di Medicina, University of Bari, Bari, Italy.
authors: Margherita
authors: M
authors: Fanelli
authors: Dipartimento di Scienze Biomediche ed Oncologia Umana, University of Bari, Bari, Italy. Electronic address: ettore.cicinelli@uniba.it.
authors: Ettore
authors: E
authors: Cicinelli
mesh_terms: D015415:Biomarkers / Q000097:blood; D016022:Case-Control Studies; D002908:Chronic Disease; D004716:Endometritis / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006801:Humans; D053583:Interleukin-1beta / Q000097:blood*; D015850:Interleukin-6 / Q000097:blood*; D008597:Menstrual Cycle / Q000097:blood*; D014409:Tumor Necrosis Factor-alpha / Q000097:blood*
chemical_list: D015415:Biomarkers; D053583:Interleukin-1beta; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha
keywords: Chronic endometritis; IL-1β; IL-6; TNF-α; cytokines; menstrual effluents