title: Influence of a loop electrosurgical excision procedure (LEEP) on levels of cytokines in cervical secretions.
abstract: Over the past decade, there has been heightened interest in determining if there is an increased risk of adverse reproductive outcomes among women who had a loop electrosurgical excision procedure (LEEP) to remove cervical intraepithelial neoplasia (CIN). The objective of this exploratory study was to determine if the treatment of CIN with a LEEP is associated with changes in cervical soluble immune markers. Cervical cytokine concentrations were measured in women treated with LEEP and a control group of women who had colposcopy only and did not undergo LEEP. Cytokines were examined in cervical secretions collected in Merocel(®) sponges at study entry and at 6-month follow-up. Cytokines were measured using a Luminex 18-plex cytokine bead assay. The mean cytokine levels were not significantly changed from baseline to follow-up in either group, with the exception of TNF-α, which decreased among women who underwent a LEEP. When the mean levels of cytokines of the treated and untreated groups at baseline or follow-up were compared, cytokine levels tended to be lower in the treated group (particularly IFN-γ, IL-6, IL-8, and MCP-1). Findings from adjusted repeated measures analyses revealed no differences between the two groups with regard to changes in cytokine levels over time. Overall, women undergoing a LEEP showed few changes in the cervical microenvironment relative to untreated women. Future studies with additional cervical environment markers and larger sample sizes are needed to determine if a LEEP is associated with dysregulation of the cervical microenvironment.
authors.affiliation: Department of Epidemiology, University of Iowa College of Public Health, 145 Riverside Drive, S427 CPHB, Iowa City, IA 52242, USA. Electronic address: audrey-saftlas@uiowa.edu.
authors.forename: Audrey F
authors.initials: AF
authors.lastname: Saftlas
authors.affiliation: Department of Genetics, University of North Carolina-Chapel Hill, 5100 Genetic Medicine Building, CB #7264, 120 Mason Farm Road, Chapel Hill, NC 27599, USA. Electronic address: cnspracklen@unc.edu.
authors.forename: Cassandra N
authors.initials: CN
authors.lastname: Spracklen
authors.affiliation: Department of Epidemiology, University of Iowa College of Public Health, 145 Riverside Drive, S435 CPHB, Iowa City, IA 52242, USA. Electronic address: kelli-ryckman@uiowa.edu.
authors.forename: Kelli K
authors.initials: KK
authors.lastname: Ryckman
authors.affiliation: Department of Obstetrics and Gynecology, Carver College of Medicine, University of Iowa, 200 Hawkins Drive, Iowa City, IA 51214, USA. Electronic address: colleen-stockdale@uiowa.edu.
authors.forename: Colleen K
authors.initials: CK
authors.lastname: Stockdale
authors.affiliation: Department of Medicine, Division of Infectious Disease, University of Pittsburgh, S804 Scaife Hall, 3550 Terrace Street, Pittsburgh, PA 15261, USA. Electronic address: kjp43@pitt.edu.
authors.forename: Kerri
authors.initials: K
authors.lastname: Penrose
authors.affiliation: Department of Obstetrics and Gynecology, University of Kansas Medical Center, 3901 Rainbow Boulevard, Mailstop 2028, Kansas City, KS 66160, USA. Electronic address: kault2@kumc.edu.
authors.forename: Kevin
authors.initials: K
authors.lastname: Ault
authors.affiliation: Department of Epidemiology, University of Iowa College of Public Health, 145 Riverside Drive, S415 CPHB, Iowa City, IA 52242, USA. Electronic address: linda-rubenstein@uiowa.edu.
authors.forename: Linda M
authors.initials: LM
authors.lastname: Rubenstein
authors.affiliation: Human Papillomavirus Immunology Laboratory, Leidos Biomedical Research, Incorporated, Frederick National Laboratory for Cancer Research, 1050 Boyles Street, Frederick, MD, USA. Electronic address: pintol@mail.nih.gov.
authors.forename: Ligia A
authors.initials: LA
authors.lastname: Pinto
mesh_terms: D000293:Adolescent; D000328:Adult; D002584:Cervix Uteri / Q000378:metabolism* / Q000601:surgery*; D016207:Cytokines / Q000378:metabolism*; D004598:Electrosurgery; D005260:Female; D006801:Humans; D002578:Uterine Cervical Dysplasia / Q000378:metabolism* / Q000601:surgery*
chemical_list: D016207:Cytokines
keywords: Cervical intraepithelial neoplasia (CIN); Cervical secretions; Cytokines; Loop electrosurgical excision procedure (LEEP)