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Characterization of intraperitoneal cytokines and nitrites in women with severe ovarian hyperstimulation syndrome
1Department of Obstetrics and Gynecology, Hadassah University Hospital, Mount Scopus, Jerusalem, Israel. revel@.yam-suff.cc.huji.ac.il
Objective:
To assess the potential involvement of cytokines and nitrites in the hyperpermeability characterizing the ovarian hyperstimulation syndrome (OHSS).
Design:
A controlled clinical study comparing peritoneal fluid (PF) from patients with severe OHSS and from non-OHSS controls.
Setting:
Women hospitalized with severe OHSS in three tertiary medical centers.
Patients:
Twelve patients with severe OHSS necessitating paracentesis and 20 non-OHSS controls.
Interventions:
The criteria for ultrasound-guided paracentesis were tense ascites, hydrothorax, hemoconcentration, or oliguria.
Main Outcome Measures:
Interleukin (IL) 1 beta IL-1 receptor agonist, IL-2, IL-6, IL-8, and tumor necrosis factor alpha (TNF alpha) levels in PF were assayed by ELISA; nitrites were measured by the "Griess" reaction. Estradiol and P were determined by RIA.
Results:
Ovarian hyperstimulation syndrome patients had significantly higher PF IL-6 (3,523 versus 30 pg/mL), TNF alpha (14 versus 4.2 pg/mL), and IL-8 (1,695 versus 900 pg/mL). In the serum, only IL-6 levels were significantly higher (375 versus 11 pg/mL). Conversely, nitrite levels were significantly lower in PF of OHSS patients (0.5 versus 34 nmol/mL). Interleukin 1 levels were higher and IL-1 receptor antagonist levels were lower in OHSS patients, suggesting potentially increased biologic potency of IL-1.
Conclusion:
These findings suggest that these substances could be involved in mediating the capillary hyperpermeability characterizing this syndrome.