Peritoneal fluid 6-keto prostaglandin F1 alpha levels in women with endometriosis

Identification of an invasive, N-cadherin-expressing epithelial cell type in endometriosis using a new cell culture model

Studies of molecular, cellular, and pathophysiological parameters in endometriosis are primarily hampered by a lack of in vitro model systems, such as endometriotic cell lines. To overcome this we successfully established cell lines from peritoneal endometriotic biopsies and characterized them at the molecular and cellular level. Two types of cells could be transformed: one exhibiting stromal cell features (cytokeratin/E-cadherin-negative), the other epithelial-like (cytokeratin-positive/E-cadherin-negative, invasive in vitro). Using a Matrigel assay the epithelial-like cell lines proved as invasive as metastatic carcinoma cells, possibly through the influence of N-cadherin implicated as a path-finding cadherin allowing cellular invasion and migration in both normal and pathophysiological processes. Our results support the idea that endometriosis, although not neoplastic, shares features with malignant cells and that metastasis in endometriosis may include mechanisms proposed for micrometastasis in cancer. Thus our cell lines will not only be useful tools for analyzing molecular and cellular events relating to endometriosis, but may also represent a paradigm for invasion and metastasis in general.

Absence of a direct effect of recombinant tumor necrosis factor-alpha on human sperm function and murine preimplantation development

OBJECTIVE

This study was designed to test the in vitro effects of human recombinant tumor necrosis factor (rTNF) on sperm motility, fertilization, and preimplantation development.

DESIGN

A sensitive enzyme immunoassay was used to determine half-lives of rTNF and confirm concentrations of cytokine throughout experimental conditions. Effect of rTNF on human sperm survival was measured by computer-assisted methodology, and effect on human sperm penetration was assessed by hamster ova penetration. Cytokine effect on murine gamete interaction was determined by in vitro fertilization (IVF). Murine preimplantation development was assessed by in vitro development of cryopreserved-thawed one-cell zygotes.

RESULTS

The half-life of rTNF was reduced by the addition of sperm to culture media (P less than 0.001). Sperm motility (P = 0.245) and hamster ova penetration (P = 0.62) were not altered by incubations in the presence of concentrations of rTNF up to 10,000 U/mL. Mouse IVF (P = 0.60) and preimplantation development (P = 0.56) were not altered by rTNF in concentrations up to 5,000 U/mL.

CONCLUSIONS

These results demonstrate rTNF by itself does not interfere with gamete function or early embryo development.

Eicosanoids in primary dysmenorrhea, endometriosis and menstrual migraine

This paper summarizes what has been learned over the years about the role of eicosanoids in the pathogenesis of primary dysmenorrhea, endometriosis and menstrual migraine. The role of prostaglandins (PGs) in the pathogenesis of primary dysmenorrhea is inferred from four main observations: firstly, the clinical symptoms of primary dysmenorrhea are similar to those induced by the administration of PGF2 alpha and PGE2 for the induction of labour; secondly, the increased production of PGs by the endometrium during the luteal and menstrual phases of ovulatory cycles is consistent with the occurrence of primary dysmenorrhea mainly in ovulatory cycles; thirdly, the concentrations of PGF2 alpha and PGE2 in the endometrium and menstrual fluid of dysmenorrheic women are significantly higher than in controls; fourthly, certain PG inhibitors have been proved to be effective in the treatment of dysmenorrhea. The change in PG production can explain the major symptoms of primary dysmenorrhea, including the increased uterine contractility, uterine ischemia and the lowering of the pain threshold to chemical and physical stimuli in the pelvic nerve terminals. Moreover, recent experimental data suggest that leukotrienes (LTs) might be among the alternative pathogenetic causes of primary dysmenorrhea. The data which support a relationship between eicosanoids and endometriosis are as follows: endometriotic tissue produces PGs; the peritoneal fluid concentration of PGF2 alpha increases significantly after the induction of endometriosis in laboratory animals; the concentration of PGs in peritoneal fluid of some patients with endometriosis is greater than in controls and, finally, the number and activation of pelvic macrophages which are able to synthesize eicosanoids increase in patients with endometriosis. Possible roles for eicosanoids in the pathogenesis of infertility and secondary dysmenorrhea induced by endometriosis have been suggested. Eicosanoids are probably also involved in the pathogenesis of menstrual migraine. Different types of PGs might play a role both in the initial vasoconstriction during the prodromal phase of migraine and in the vasodilation and sensitization to pain typical of the pain phase.

Peritoneal fluid environment and infertility

The PF environment is one that hosts the processes of ovulation, gamete transportation, fertilization, and early embryonic development. The cellular and acellular constituents of this dynamic fluid are in a constant interactive state, being influenced by the physiologic events of the menstrual cycle and pelvic disease processes; these constituents probably influence disease manifestation and reproduction. The importance of understanding this zone of early reproductive life has been now recognized. We hope that future investigations will define the exact role(s) of known components and some yet-to-be defined substances of PF in disease processes that affect reproductive function. With better understanding of normal and abnormal events in this pelvic microenvironment, we can develop rationales for novel treatment modalities.

Cul-de-sac fluid in women with endometriosis: fluid volume, protein and prostanoid concentration during the periovulatory period--days 13 to 18

Cul-de-sac fluid from women with histologically confirmed endometriosis (n = 45) or from infertile women without evidence of endometriosis (n = 28) was collected at the time of laparoscopy during the periovulatory period (days 13 to 18). This fluid was analyzed for prostaglandin E2 (PGE2), prostaglandin F2a (PGF2a), 13,14-dihydro-15 keto-PGF2a (PGFM), and thromboxane B2 (TXB2) by radioimmunoassay (RIA). Protein content of the fluid also was determined. No difference (P greater than 0.05) in cul-de-sac fluid volume was found between women with and without endometriosis, nor were differences detected in the level of any of the prostanoids measured in fluid from infertile control patients compared with those with endometriosis. This was true regardless of whether the prostanoids were expressed as a concentration, total amount in fluid, or as a ratio of prostanoid to protein content. The present study does not support the theory that cul-de-sac fluid prostanoids provide a useful diagnostic index of endometriosis.