GnRHa及反加雌孕激素对子宫内膜异位症患者外周血及腹腔液IL-2和IL-6分泌的影响

目的比较单用GnRHa及反加雌孕激素对子宫内膜异位症(内异症)患者外周血及腹腔液IL-2及IL-6分泌的影响。方法分离外周血单个核细胞(peripheral blood mononuclear cell,PBMC)加植物血凝素诱生培养,采用酶联免疫吸附法检测28例内异症组患者和10例正常对照组C培养液上清和腹腔液中IL-2和IL-6的水平;内异症组随机分为单用GnRHa组(A组)和反加组(B组),用药治疗3月后,比较PBMC培养上清中IL-2和IL-6的水平。结果A、B两组患者术前培养液上清和腹腔液中IL-6水平显著高于对照组C(P<0.05),IL-2/IL-6比值显著低于对照组C(P<0.05);用药治疗3个月后,A、B两组患者培养液上清IL-6分泌较术前明显下降(P<0.01),IL-2/IL-6比值较术前明显升高(P<0.05),两治疗组间差异无统计学意义。结论内异症患者培养上清液和腹腔液中IL-6的升高可能与内异症的发生有关;内异症患者Th1/Th2比例失衡使细胞免疫抑制,从而使异位内膜逃避免疫监视而广泛种植;术后单用GnRHa和反加治疗内异症均能部分逆转Th2优势,具有相似的效果。

Compare the changes of secretion of IL-2 and IL-6 in patients with endometriosis after the treatment of gonadotropin releasing hormone agonist(GnRHa) and estroprogestin

Objective To compare the changes of secretion of IL-2 and IL-6 in patients with endometriosis after the treatment of gonadotropin releasing hormone agonist and estroprogestin.Methods Using enzyme linked immunoabosorbent assay to detect the levels of interleukine-2(IL-2)and interleukine-6(IL-6)in supernatants of cultured PHA induced peripheral blood mononuclear cell(PBMC)and peritoneal fluid.Totally,28 endometriosis cases and 10 non-endometriosis cases were allocated and compared in this experiment.Endometriosis cases were randomly divided into two groups:GnRHa group(Group A)and GnRHa plus add-back therapy group(Group B).In both groups,the levels of IL-2 and IL-6 in supernatants of cultured PHA were detected after 3-month treatment.Results Compared with non-endometriosis cases group,the level of IL-6 in the supernatants of cultured PHA induced PBMC and peritoneal fluid of endometriosis groups were significantly increased(P <0.05);the ratio of IL-2/IL-6 in the supernatants and peritoneal fluid of both endometriosis groups was significantly lower than that of the non-endometriosis group(P < 0.05).After 3-month treatment,in both endometriosis groups,the level of IL-6 in the supernatants was significantly decerased,while the radio of IL-2/IL-6 was remarkably increased(P <0.05,respectively).The difference between two endometriosis groups was not statistically significant.Conclusions The ascended levels of IL-6 in the supernatants and peritoneal fluid of both endometriosis groups infers that the increased level of IL-6 is possibly involved in the pathophysiology of endometriosis.The imbalance of Th1/Th2 leads to the depressed cell-mediated immune responses,which causes defect immunosurveillance and ectopic overgrowth of endometriotic tissues.Both the treatments of GnRHa alone and GnRHa plus add-back therapy lead to similar effects,which can be recognized as partly reverse the imbalance towards Th2.