CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDS

Uterine fibroids take a second place in the structure of gynecological diseases, after inflammation of genital organs, with a share of 40%. The aim of the study was to investigate cytokine profile and factors of immune dysfunction in patients with uterine fibroids complicated by hemorrhagic syndrome...

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Main Authors: N. F. Khvorostukhina, A. E. Ostrovskaya, D. A. Novichkov, N. N. Stepanova
Format: Article
Language:Russian
Published: St. Petersburg branch of the Russian Association of Allergologists and Clinical Immunologists 2017-12-01
Series:Медицинская иммунология
Subjects:
Online Access:https://www.mimmun.ru/mimmun/article/view/1397
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author N. F. Khvorostukhina
A. E. Ostrovskaya
D. A. Novichkov
N. N. Stepanova
author_facet N. F. Khvorostukhina
A. E. Ostrovskaya
D. A. Novichkov
N. N. Stepanova
author_sort N. F. Khvorostukhina
collection DOAJ
description Uterine fibroids take a second place in the structure of gynecological diseases, after inflammation of genital organs, with a share of 40%. The aim of the study was to investigate cytokine profile and factors of immune dysfunction in patients with uterine fibroids complicated by hemorrhagic syndrome during a course of hormone replacement therapy.А detailed comparative analysis of a survey was performed in 95 women with uterine fibroids. Tumor size did not exceed 12 weeks of pregnancy, mainly with intramural and subserous localization of nodes, having indications for conservative treatment. The main group consisted of 43 patients with uterine fibroids and clinical signs of hemorrhagic syndrome observed in the course of hormone replacement therapy (Buserelindepot 3.75 mg). In a comparison group (n = 52), treatment of fibroids with hormonal therapy was not carried out.A control group comprised healthy women (n = 27). The survey consisted of a comprehensive ultrasound scan with Doppler ultrasound apparatus HITACHI 5500. The immune parameters were evaluated as contents of cytokines (interleukins IL-1β, IL-4, IL-6, IL-2, IFNγ, TNFα) and levels of the Fas-ligand apoptosis marker in blood serum using solid-phase immunoassay technique. For identification of urogenital infection pathogens, methods of diagnostic PCR and ELISA were used.The results of the study were as follows: it is established that emergence of hemorrhagic syndrome on the during hormone therapy for uterine fibroids is associated with activation of latent forms of urogenital infections, being a probable result of potentiating immunosuppressive action of hormonal drugs that promote alterations of immune status, reduction of Th1 and Th2 lymphocyte functions, as well as significant inhibition of apoptosis. In the main group, IL-1β, IL-2, IL-4, IL-6 and IFNγ concentrations were decreased by 1.3 to 1.5 – fold, whereas TNFα and FasL contents were 2 times lower than the levels in control group. In addition, qualitative analysis of uterine hemodynamics has shown that the complications associated with hormone therapy of uterine fibroids are accompanied by a significant increase of the systolic blood flow velocity in the uterine arteries (1.8%), against decrease in diastolic blood flow (2.5 times) and increased resistance index of the vascular wall (1.6 times), as compared with appropriate parameters in healthy women. In conclusion, the received data suggest a need for more detailed examination of women, in order to detect chronic forms of urogenital infections, by means of improving conservative treatment strategies of uterine fibroids, reducing frequency of complications and effectiveness of hormone therapy
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spelling doaj.art-3e568cd880f447d6b68788552d6f6a322024-04-22T13:07:42ZrusSt. Petersburg branch of the Russian Association of Allergologists and Clinical ImmunologistsМедицинская иммунология1563-06252313-741X2017-12-0119673974810.15789/1563-0625-2017-6-739-748968CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDSN. F. Khvorostukhina0A. E. Ostrovskaya1D. A. Novichkov2N. N. Stepanova3Saratov State V.I. Razumovsky Medical UniversitySaratov State V.I. Razumovsky Medical UniversitySaratov State V.I. Razumovsky Medical UniversitySaratov State V.I. Razumovsky Medical UniversityUterine fibroids take a second place in the structure of gynecological diseases, after inflammation of genital organs, with a share of 40%. The aim of the study was to investigate cytokine profile and factors of immune dysfunction in patients with uterine fibroids complicated by hemorrhagic syndrome during a course of hormone replacement therapy.А detailed comparative analysis of a survey was performed in 95 women with uterine fibroids. Tumor size did not exceed 12 weeks of pregnancy, mainly with intramural and subserous localization of nodes, having indications for conservative treatment. The main group consisted of 43 patients with uterine fibroids and clinical signs of hemorrhagic syndrome observed in the course of hormone replacement therapy (Buserelindepot 3.75 mg). In a comparison group (n = 52), treatment of fibroids with hormonal therapy was not carried out.A control group comprised healthy women (n = 27). The survey consisted of a comprehensive ultrasound scan with Doppler ultrasound apparatus HITACHI 5500. The immune parameters were evaluated as contents of cytokines (interleukins IL-1β, IL-4, IL-6, IL-2, IFNγ, TNFα) and levels of the Fas-ligand apoptosis marker in blood serum using solid-phase immunoassay technique. For identification of urogenital infection pathogens, methods of diagnostic PCR and ELISA were used.The results of the study were as follows: it is established that emergence of hemorrhagic syndrome on the during hormone therapy for uterine fibroids is associated with activation of latent forms of urogenital infections, being a probable result of potentiating immunosuppressive action of hormonal drugs that promote alterations of immune status, reduction of Th1 and Th2 lymphocyte functions, as well as significant inhibition of apoptosis. In the main group, IL-1β, IL-2, IL-4, IL-6 and IFNγ concentrations were decreased by 1.3 to 1.5 – fold, whereas TNFα and FasL contents were 2 times lower than the levels in control group. In addition, qualitative analysis of uterine hemodynamics has shown that the complications associated with hormone therapy of uterine fibroids are accompanied by a significant increase of the systolic blood flow velocity in the uterine arteries (1.8%), against decrease in diastolic blood flow (2.5 times) and increased resistance index of the vascular wall (1.6 times), as compared with appropriate parameters in healthy women. In conclusion, the received data suggest a need for more detailed examination of women, in order to detect chronic forms of urogenital infections, by means of improving conservative treatment strategies of uterine fibroids, reducing frequency of complications and effectiveness of hormone therapyhttps://www.mimmun.ru/mimmun/article/view/1397uterine fibroidscytokinesdoppler sonographyurogenital infectionshormone therapycomplications
spellingShingle N. F. Khvorostukhina
A. E. Ostrovskaya
D. A. Novichkov
N. N. Stepanova
CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDS
Медицинская иммунология
uterine fibroids
cytokines
doppler sonography
urogenital infections
hormone therapy
complications
title CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDS
title_full CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDS
title_fullStr CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDS
title_full_unstemmed CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDS
title_short CYTOKINE PROFILE IN COMPLICATIONS OF HORMONE THERAPY ADMINISTERED FOR UTERINE FIBROIDS
title_sort cytokine profile in complications of hormone therapy administered for uterine fibroids
topic uterine fibroids
cytokines
doppler sonography
urogenital infections
hormone therapy
complications
url https://www.mimmun.ru/mimmun/article/view/1397
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