Elevated interleukin-6 levels in peritoneal fluid of patients with pelvic pathology
R P Buyalos1, V A Funari, R Azziz
1University of California, Los Angeles (UCLA) Medical Center.
Insights
Interleukin 6 (IL-6) is present in peritoneal fluid (PF) in all women. Elevated IL-6 levels are associated with pelvic adhesions, but not endometriosis.
Area of Science:
- Reproductive immunology
- Gynecologic pathology
- Cytokine research
Background:
- Interleukin 6 (IL-6) is a key cytokine involved in inflammatory processes.
- The presence and significance of IL-6 in peritoneal fluid (PF) in relation to pelvic conditions are not fully understood.
Purpose of the Study:
- To investigate whether IL-6 is a normal component of PF.
- To determine if pelvic pathologies, specifically endometriosis and pelvic adhesions, affect IL-6 concentrations in PF.
Main Methods:
- Peritoneal fluid samples were collected from 73 women during laparoscopy.
- IL-6 levels were quantified using a specific sandwich enzyme-linked immunosorbent assay (ELISA).
- Participants included women with endometriosis, non-endometriotic pelvic adhesions, and healthy controls.
Main Results:
- Immunoreactive IL-6 was detected in all subjects' PF.
- Mean IL-6 concentrations were significantly higher in women with pelvic adhesions compared to controls (P < 0.03).
- No significant difference in mean IL-6 levels was observed between women with endometriosis and controls (P = 0.38).
- Elevated IL-6 levels (>1.0 ng/mL) were more common in patients with pelvic adhesions than controls (P < 0.02).
Conclusions:
- IL-6 is a normal constituent of human peritoneal fluid.
- Elevated IL-6 concentrations in PF are associated with pelvic adhesions.
- IL-6 levels do not appear to be significantly altered by endometriosis in the PF microenvironment.
Objective:
To determine if interleukin 6 (IL-6) is a normal constituent of peritoneal fluid (PF), and if various types of pelvic pathology influence its presence within the PF microenvironment.
Study Design:
Peritoneal fluid from 73 women obtained at the time of laparoscopy was examined for the presence of IL-6 using an IL-6 specific sandwich enzyme-linked immunosorbent assay. Thirty-nine patients had pelvic endometriosis, 17 had nonendometriotic pelvic adhesive disease, and 17 subjects undergoing tubal sterilization without evidence of pelvic pathology served as controls.
Results:
Immunoreactive IL-6 was observed in the PF of all 73 subjects (range 0.26 to 11.16 ng/mL). The mean concentration of IL-6 was higher in women with nonendometriotic pelvic adhesions as compared with control subjects (1.28 +/- 0.16 versus 0.80 +/- 0.06 ng/mL, P less than 0.03). There was no difference in the mean peritoneal concentrations of IL-6 between women with endometriosis (1.16 +/- 0.28 ng/mL) and controls, P = 0.38. Twenty-seven of 73 patients (37%) demonstrated elevated levels (greater than 1.0 ng/mL) of IL-6. Patients with pelvic adhesions were significantly more likely to have elevated concentrations of IL-6 than controls (10/17 [59%] versus 3/17 [18%], P less than 0.02). Alternatively, the percentage of patients with elevated IL-6 concentrations did not differ between patients with endometriosis or controls (14/39 [36%] versus 3/17 [18%], P greater than 0.10).
Conclusions:
These findings demonstrate that IL-6 is a normal constituent of PF and that elevated levels are found in many patients with pelvic adhesions.
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