title: Surgical removal of endometriotic lesions alters local and systemic proinflammatory cytokines in endometriosis patients.
abstract: OBJECTIVE
  To determine the impact of endometriotic lesion removal on local and systemic inflammation.
  
  
  METHODS
  Multiplex cytokine analysis on samples from endometriosis patients before surgery, 2 weeks after surgery, and 3 months after surgery.
  
  
  METHODS
  Academic teaching hospital and university.
  
  
  METHODS
  A total of 43 endometriosis patients before and after excision of lesions by means of laparoscopic surgery, and 25 normal women.
  
  
  METHODS
  None.
  
  
  METHODS
  Plasma, eutopic and ectopic tissue, and peritoneal fluid cytokine levels.
  
  
  RESULTS
  Compared with presurgery plasma samples, levels of granulocyte-macrophage colony-stimulating factor (GM-CSF), interleukin (IL) 2, IL-8, and IL-10 decreased significantly by 2 weeks after surgery in endometriosis patients. Interestingly, levels began to rise at 3 months after surgery in most cases. In tissue, levels of GM-CSF and IL-15 were lower in eutopic tissue, while levels of basic fibroblast growth factor, interferon-inducible protein 10, IL-1 receptor antagonist, granulocyte colony-stimulating factor, macrophage inflammatory protein 1β, IL-7, and IL-5 were higher in eutopic than in ectopic tissue. In peritoneal fluid, levels of IL-5 and IL-12 were higher in early versus advanced stages of endometriosis. Compared with normal women, plasma from endometriosis patients had higher levels of inflammatory cytokines.
  
  
  CONCLUSIONS
  Endometriotic lesion removal significantly alters the inflammatory profile both locally and systemically in women with endometriosis. Our findings indicate that ectopic lesions are the major drivers of systemic inflammation in endometriosis. The transitory nature of the change may reflect the recurrence of the condition and the influence of systemic factors in its onset.
authors.affiliation: Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: Stephany P
authors.initials: SP
authors.lastname: Monsanto
authors.affiliation: Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: Andrew K
authors.initials: AK
authors.lastname: Edwards
authors.affiliation: Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina.
authors.forename: Juhua
authors.initials: J
authors.lastname: Zhou
authors.affiliation: Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina.
authors.forename: Prakash
authors.initials: P
authors.lastname: Nagarkatti
authors.affiliation: Department of Pathology, Microbiology, and Immunology, University of South Carolina School of Medicine, Columbia, South Carolina.
authors.forename: Mitzi
authors.initials: M
authors.lastname: Nagarkatti
authors.affiliation: Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
authors.forename: Steven L
authors.initials: SL
authors.lastname: Young
authors.affiliation: Department of Obstetrics and Gynecology, Greenville Health Systems, Greenville, South Carolina.
authors.forename: Bruce A
authors.initials: BA
authors.lastname: Lessey
authors.affiliation: Department of Biomedical and Molecular Sciences, Queen's University, Kingston, Ontario, Canada. Electronic address: tayadec@queensu.ca.
authors.forename: Chandrakant
authors.initials: C
authors.lastname: Tayade
mesh_terms: D000328:Adult; D015415:Biomarkers; D016207:Cytokines / Q000097:blood*; D004715:Endometriosis / Q000097:blood* / Q000175:diagnosis / Q000601:surgery*; D005260:Female; D016178:Granulocyte-Macrophage Colony-Stimulating Factor / Q000097:blood; D006801:Humans; D018836:Inflammation Mediators / Q000097:blood*; D010535:Laparoscopy / Q000379:methods / Q000639:trends*; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; D018836:Inflammation Mediators; D016178:Granulocyte-Macrophage Colony-Stimulating Factor
keywords: Cytokines; endometriosis; inflammation; plasma