6-ketoprostaglandin-f1-alpha and Endometriosis

The gynecologic and obstetric implications of the smooth muscle-relaxing, antiaggregatory prostacyclin and its endogenous antagonist, thromboxane A2, are reviewed. In addition to the vascular wall and circulating platelets, which are primary sources for prostacyclin and thromboxane A2, respectively, reproductive tissues produce great amounts of these prostanoids, evidently for the regulation of the vascular tone and/or vascular platelet interaction. Several gynecologic and obstetric disorders are characterized by abnormalities in prostacyclin and/or thromboxane A2. In primary menorrhagia the uterine release of prostacyclin is increased, and consequently menstrual blood loss can be reduced with various prostaglandin synthesis inhibitors. Prostacyclin relaxes the nonpregnant myometrium in vitro and may also do so in vivo, although intravenous infusion of prostacyclin has no effect upon the uterine contractility in nonpregnant or pregnant subjects. Patients with pelvic endometriosis may have increased levels of prostacyclin and thromboxane A2 metabolites in the peritoneal fluid. The prostacyclin/thromboxane A2 balance shifts to thromboxane A2 dominance in patients with gynecologic cancer. During pregnancy the production of prostacyclin and thromboxane A2 increases in the mother and fetoplacental tissue. Preeclampsia and other chronic placental insufficiency syndromes are accompanied by prostacyclin deficiency in the mother and in fetomaternal tissues and by an overproduction of thromboxane A2, at least in the placenta. These changes may account for the vasoconstriction and platelet hyperactivity, which are pathognomonic for hypertensive pregnancies. By directing the prostacyclin/thromboxane A2 balance to prostacyclin dominance (by dietary manipulation, administration of prostacyclin and/or its analogues, drugs with prostacyclin-stimulating and/or thromboxane A2-inhibiting action), it may be possible to prevent and/or treat hypertensive pregnancy complications in the future.

Topics: 6-Ketoprostaglandin F1 alpha; Animals; Ascitic Fluid; Endometriosis; Epoprostenol; Estrogens; Female; Genital Diseases, Female; Genital Neoplasms, Female; Humans; Hypertension; Menorrhagia; Platelet Aggregation; Pre-Eclampsia; Pregnancy; Pregnancy Complications; Pregnancy Complications, Cardiovascular; Progestins; Thromboxane A2; Thromboxane B2; Thromboxanes; Uterine Contraction; Vasoconstriction

To observe the therapeutic effect of ear-electroacupuncture (Ear-EA) on dysmenorrhea in patients with endometriosis and to explore its underlying mechanism.. A total of 80 endometriosis patients were randomly and equally divided into ear-EA group and body-EA group. EA (50 Hz, 0.5-0.8 mA) was applied to auricular points (Uterus, Subcortex, Shenmen, Endocrine, etc.) and body acupoints [Tianshu (ST 25), Qihai (CV 6), Guanyuan (CV 4), Sanyinjiao (SP 6), Diji (SP 8), Uterus (EX-CA 1), etc.] respectively for 30 min, once every other day for 3 months. Dysmenorrhea severity score (DSS) was assessed and plasma prostaglandin (PGE2) and 6-Keto-PGF1alpha levels detected by radioimmunoassay.. Compared with pre-treatment, DSS lowered significantly during the 1st and 2nd menstrual cycle in body-EA group, and during the 1st, 2nd and 3rd menstruation in ear-EA group; and the DSS of ear-EA group during the 3rd menstruation was evidently lower than that of body-EA group (P < 0.05). During the 3rd menstrual onset after the treatment, plasma PGE2 contents in both groups decreased obviously (P < 0.01), and plasma 6-Keto-PGF1alpha, levels increased considerably in comparison with pre-treatment (P < 0.01). Comparison between two groups during the 3rd menstruation showed that plasma PGE2 level of ear-EA group was markedly lower than that of body-EA group, and 6-Keto-PGF1alpha, level of ear-EA group was significantly higher than that of body-EA group (P < 0.05). No significant difference was found between two groups in clinical therapeutic effect (P > 0.05).. Both ear-EA and body-EA can effectively relieve endometriosis-induced dysmenorrhea, and the former is superior to the later in reducing pain severity, which may be closely related to their effects in reducing plasma PGE2 and raising 6-Keto-PGF1alpha level.

Topics: 6-Ketoprostaglandin F1 alpha; Acupuncture Points; Acupuncture, Ear; Adult; Dysmenorrhea; Electroacupuncture; Endometriosis; Female; Humans; Prostaglandins

48 cases of endometriosis were treated with the Neiyi (ectopic endometrium) No. 2 Pills [symbol: see text] 2 [symbol: see text]) composed of fresh Dahuang (Radix et Rhizoma Rhei), Biejia (Carapax Trionycis) and Taoren Shuang (powdered Semen Persicae). After 3 months of treatment, high effective rates were obtained in menorrhalgia, dyspareunia, proctalgia, hysteromyoma, ovary cyst, and tubercles in the pelvic cavity, with a pregnant rate of as high as 26.7% in sterility. Meanwhile, the levels of plasma PGF2 alpha and PGE2 markedly dropped, while that of 6-keto-PGF1 alpha, beta-EP, and HYP significantly elevated.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; beta-Endorphin; Dinoprost; Dinoprostone; Drugs, Chinese Herbal; Endometriosis; Female; Humans; Pelvis; Thromboxane B2

The relationship between prostaglandins (PGs) production and the mechanism of dysmenorrhea in endometriosis is poorly understood. Consequently, we investigated the role of PGs in dysmenorrhea of endometriosis. Slices of normal endometrium, normal myometrium, adenomyosis, leiomyoma, normal ovary and affected ovary were incubated. 6-keto PGF1 alpha (a metabolite of PGI2), TXB2 (a metabolite of TXA2), PGF2 alpha and PGE2 concentrations of the incubation medium were measured by RIA. The results are as follows; 1) PGs production in endometriosis was significantly higher than that of other tissues, especially 6-keto PGF1 alpha, which was a dominant product in adenomyosis. 2) There were significant differences in PGs production between severe dysmenorrhea and non dysmenorrhea, especially tissue of adenomyosis with severe dysmenorrhea which produces large amounts of 6-keto PGF1 alpha. 3) There seems to be interaction between normal endometrium and normal myometrium with regard to 6-keto PGF1 alpha production. We concluded that increased PGI2 in the tissue of endometriosis seems to induce hyperalgesia during menstruation.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Endometriosis; Endometrium; Epoprostenol; Female; Humans; Hyperalgesia; Myometrium; Ovarian Diseases; Ovary; Prostaglandins; Thromboxane B2

To study the production of prostacyclin (PGI2) and thromboxane A2 (TxA2) in endometriosis in vitro, samples of endometriotic tissue taken during operation from 6 women were superfused for 4.5 hours in 95% O2/5% CO2 at 37 degrees C, and the stable metabolites of PGI2 (=6-keto-PGF1 alpha), and TxA2 (=TxB2) were measured by radioimmunoassays from the superfusates. All samples studied produced 6-keto-PGF1 alpha in the range from 0.2 to 10.5 nanograms/gram of dry tissue/minute with a mean of 3.6 ng/g/min during the whole experiment. TxB2 was also released by each sample at rates between 0.2 and 11.9 ng/g/min (mean 2.6 ng/g/min). The production of these prostanoids tended to be greater in the serosal (n = 2) than in the ovarian (n = 4) endometriosis. The addition of indomethacin of 10(-5) - 10(-3) moles/l to the superfusion medium inhibited concentration-dependently the synthesis of these prostanoids. Apart from these in vitro data implying the production of PGs in endometriosis, 18 patients with pelvic endometriosis sustained no relief for their endometriotic symptoms from the treatments with three anti-prostaglandins (acetylsalicylic acid, indomethacin, tolfenamic acid) in a double-blind, placebo-controlled trial.

Topics: 6-Ketoprostaglandin F1 alpha; Aspirin; Clinical Trials as Topic; Endometriosis; Epoprostenol; Female; Humans; In Vitro Techniques; Indomethacin; ortho-Aminobenzoates; Prostaglandin Antagonists; Prostaglandins; Thromboxane A2; Thromboxane B2; Thromboxanes

Do platelets play any role in the development of endometriosis?. Activated platelets aggregate in endometriotic lesions and play important roles in the development of endometriosis.. Platelets play important roles in cancer development and metastasis but there is no published study on their role in the development of endometriosis, even though endometriotic lesions undergo repeated cycles of tissue injury and repair, which characteristically involve platelets.. Cross-sectional clinical studies of women with and without endometriosis, in vitro experimentation, and animal studies using platelet and/or macrophage depletion.. Immunohistochemistry analysis of ectopic/eutopic endometrial tissues from 58 women with and 47 without endometriosis. Proliferation assay, cell cycle analysis by flow cytometry, gene expression and protein analysis for COX-2, VEGF, MMP-9, and Bcl-2 using primary cell culture, and evaluation of the rate of platelet activation induced by peritoneal fluid from women with and without endometriosis. Two mouse experiments, one that evaluated the effect of platelet depletion on lesion development and its associated phenotypic changes, and the other, the effect of platelet and/or macrophage depletion.. We found that platelets aggregated in endometriotic lesions, concomitant with elevated VEGF expression and microvessel density. Co-culture of endometriotic stromal cells with platelets enhanced cellular proliferation, and increased the expression of COX-2, MMP-9, VEGF, and Bcl-2. IL-1β-induced COX-2 up-regulation and increased production of the coagulant TXA(2) in endometriotic stromal cells. Tissue factor (TF) expression was elevated in endometriosis and TF concentrations were significantly elevated both in the supernatant of cultured primary endometriotic stromal cells and in peritoneal fluid from women with endometriosis. Platelet depletion resulted in significantly reduced lesion size and improved hyperalgesia in mice with induced endometriosis.. This study is limited by its cross-sectional design and by its focus on ovarian endometriomas.. The demonstration that platelets are involved in the development of endometriosis provides a rationale for the use of anti-coagulants to treat endometriosis, and opens prospects for developing novel biomarkers for diagnostic or prognostic purposes.. Financial support for this study was provided by grants from the National Science Foundation of China, a grant from the Shanghai Science and Technology Commission, support from the Key Specialty Project of the Ministry of Health, People's Republic of China. None of the authors has any conflict of interest to disclose.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Animals; Blood Platelets; Cell Cycle; Cell Proliferation; Cross-Sectional Studies; Endometriosis; Endometrium; Female; Gene Expression Profiling; Gene Expression Regulation; Healthy Volunteers; Humans; Interleukin-1beta; Macrophages; Male; Mice; Mice, Inbred C57BL; Ovary; Platelet Activation; Platelet Aggregation; Prognosis; Thrombin; Thromboplastin; Thromboxane B2

To investigate the effect of targeted interruption of cyclooxygenase-2 (COX-2) gene by small interference RNA (siRNA) on the expression of COX-2, vascular endothelial growth factor (VEGF) and matrix metalloproteinase-9 (MMP-9) in eutopic and ectopic endometrial stromal cells (ESC) with endometriosis, and the effect on the content of 6-keto-prostaglandin-F1α (6-keto-PGF1α, metabolites of COX) and the apoptosis of eutopic and ectopic ESC with endometriosis.. Ectopic and eutopic ESC from 30 women with endometriosis were isolated and cultured respectively. Then, ESC were classified into three groups: interference group, negative control group and blank control group. ESC in interference group were injected into siRNA transfection complex while ESC in negative control group were injected into negative control transfection complex. ESC from 10 participants without endometriosis were the normal control group. The mRNA and protein expression of COX-2, VEGF, MMP-9 in pre-transfected and post-transfected eutopic and ectopic ESC were detected through real time reverse transcription PCR and western blot. The content of 6-keto-PGF1α was determined by ELISA, the apoptotic cells were detected by flow cytometry.. After interruption of COX-2 gene, there were no significant difference in the mRNA and protein expression of COX-2, VEGF and MMP-9 between the negative control group and blank control group (P > 0.05); the mRNA and protein expression of the three genes in interference group were significantly lower than those in negative control group and blank control group (P < 0.05); the mRNA expression of the three genes in interference group of eutopic ESC were 0.87 ± 0.06, 1.76 ± 0.59, 1.04 ± 0.32, in interference group of ectopic ESC were 0.75 ± 0.12, 1.62 ± 0.47, 0.88 ± 0.25, the protein expression of the three genes in interference group of eutopic ESC were 0.457 ± 0.019, 0.500 ± 0.012, 0.361 ± 0.008, in interference group of ectopic ESC were 0.323 ± 0.018, 0.474 ± 0.016, 0.339 ± 0.009; the mRNA and protein expression of the three genes in ectopic ESC had a more reduction than those in eutopic ESC (P < 0.05). The results from ELISA revealed that the content of 6-keto-PGF1α in the normal control group [(17.7 ± 1.9) pg/ml] were significantly lower than those in the blank control group (P < 0.05), the content of 6-keto-PGF1α in ectopic ESC were significantly higher than that in eutopic ESC (P < 0.05), the content of 6-keto-PGF1α in the blank control group of eutopic and ectopic ESC were (32.4 ± 2.6) pg/ml, (38.2 ± 3.7) pg/ml; there was no significant difference in the content of 6-keto-PGF1α between the negative control group and blank control group (P > 0.05); compared with those of negative control group and blank control group, the content of 6-keto-PGF1α in interference group decreased significantly (P < 0.05), the content of 6-keto-PGF1α in interference group of eutopic and ectopic ESC were (17.1 ± 2.4) pg/ml, (20.9 ± 2.7) pg/ml; the content of 6-keto-PGF1α in eutopic ESC had a slightly more reduction than that in ectopic ESC (P > 0.05). The results from flow cytometry displayed that, there was no significant difference in apoptotic cells between the negative control group and blank control group (P > 0.05); compared with those of negative control group and blank control group, more apoptotic cells were detected in interference group and the difference was significant (P < 0.01); the apoptotic cells in ectopic ESC were significantly more than that in eutopic ESC (P < 0.05); the apoptosis rate in interference group of eutopic and ectopic ESC were (33.76 ± 0.06)%, (47.18 ± 0.12)%.. Our results suggested the targeted interruption of COX-2 gene by siRNA effectively inhibited the mRNA and protein expression of COX-2, VEGF and MMP-9 in both eutopic ESC and ectopic ESC with endometriosis, greatly increased the apoptotic rate of cells and obviously reduced the content of 6-keto-PGF1α by inhibiting the activity of COX-2. And the changes in ectopic endometrium were more evident than those in eutopic endometrium.

Topics: 6-Ketoprostaglandin F1 alpha; Apoptosis; Cyclooxygenase 2; Endometriosis; Endometrium; Epithelial Cells; Female; Humans; Matrix Metalloproteinase 9; RNA, Messenger; RNA, Small Interfering; Stromal Cells; Vascular Endothelial Growth Factor A

To test for differences in the amount and activity of peritoneal macrophages present in the peritoneal fluid of women with, and without endometriosis using prostaglandin release by macrophages in culture as a marker.. Women of reproductive age undergoing laparoscopy for infertility or chronic pelvic pain with postoperative diagnosis of endometriosis and women undergoing laparoscopy for sterilization.. Peritoneal fluid was aspirated during laparascopy, volume was recorded, macrophages were isolated via a Ficoll Paque gradient and kept in primary culture. PGE2 and PGF2 alpha release of the cells were measured before and after stimulation with zymosan.. Women with endometriosis had significantly more peritoneal macrophages than controls. Peritoneal macrophages of women with endometriosis released significantly more PGE2 than those of the control group: 8.4 +/- 2.0 versus 1.4 +/- 0.4 ng/ml/10(6) cells (mean +/- SEM, p = 0.0005) and PGF2 alpha: 10 +/- 4.3 (endometriosis) versus 1.8 +/- 0.4 (control) ng/ml/10(6) cells (mean +/- SEM, p = 0.045).. There is a significant increase in the amount of prostaglandins released by peritoneal macrophages from women with endometriosis. These prostaglandins might alter uterine and tubal contractility, thereby affecting fertility.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Ascitic Fluid; Dinoprost; Dinoprostone; Endometriosis; Extracellular Space; Female; Humans; Infertility; Macrophages, Peritoneal; Thromboxane B2

The role of prostaglandins (PGs) in dysmenorrhea of endometriosis is poorly understood. The relationship between dysmenorrheic severity and prostaglandin production was investigated in endometriosis. Slices of normal myometrium, adenomyosis, normal ovary and endometrial cyst were incubated. 6-Keto-PGF1 alpha (a metabolite of PGI2), TXB2 (a metabolite of TXA2), PGF2 alpha, and PGE2 concentrations of the incubation medium were measured by RIA. The results showed that 6-keto-PGF1 alpha production in adenomyosis and endometrial cyst were significantly higher than those in normal myometrium and ovary. A direct relationship between the degree of dysmenorrheic severity and PGs production in tissue in endometriosis was observed.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Dinoprost; Dinoprostone; Dysmenorrhea; Endometriosis; Female; Humans; Middle Aged; Ovary; Prostaglandins; Thromboxane B2; Uterus

In order to investigate the production of eicosanoids in human endometrium, myometrium, leiomyoma, adenomyosis, normal ovary, non-endometrial cyst and endometrial cyst, slices of each tissue were incubated. 6-Keto-prostaglandin (PG) F1 alpha, thromboxane (TX) B2, PGF2 alpha and PGE2 concentrations in the incubation medium were measured by direct RIA. 6-Keto-PGF1 alpha production of adenomyosis was significantly higher than that of endometrium, myometrium and leiomyoma, especially in the menstrual phase. The production of eicosanoids in endometrial cyst was significantly higher than that of non-endometrial cyst and normal ovary. These results suggest that endometriosis is associated with increased eicosanoid production in vivo.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Cysts; Dinoprost; Dinoprostone; Eicosanoids; Endometriosis; Female; Humans; Leiomyoma; Middle Aged; Myometrium; Ovary; Thromboxane B2; Uterine Neoplasms

In order to study a direct effect of some traditional and western medicine on the prostaglandins (PGs) of endometriosis, endometriotic cell and endometrial cell in situ were cultured in vitro. 6-keto-PGF1 alpha and thromboxane (TXB2) were measured in the above cells using the RIA from the superfusates. These PGs changes after gossypol acetate, progesterone, danazol and gonadotrophin releasing hormone agonist (GnRHa) treatment were studied. High PGs levels were observed in endometriotic cell, and higher in endometrial cell in situ of patients than in endometrial cell of healthy persons (P less than 0.01). After treatment with drug (but not GnRHa), the prostacyclin (PGI2) and TXB2 content were reduced in endometriotic cell, and the TXB2 contents were reduced in endometrial cell in situ (P less than 0.01). These results indicate that endometriotic cell and endometrial cell in situ can produce more PGI2 and TXB2--at least in vitro, which perhaps may provide an explanation for the puzzling clinical phenomenon of endometriosis. Gossypol acetate, progesterone and danazol inhibit PGI2 and TXB2 content in endometrial cell of patients with endometriosis. It is pertinent to ask whether these drugs can be used to improve endometriosis-associated infertility or dysmenorrhea as well.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Endometriosis; Endometrium; Female; Gonadotropin-Releasing Hormone; Gossypol; Humans; Pelvic Neoplasms; Thromboxane B2

In order to investigate whether prostanoids are involved in the pathophysiology of endometriosis, prostaglandin and leukotriene concentrations in peritoneal fluid were measured in adenomyosis, ovarian chocolate cyst and uterine leiomyoma. In the secretory phase, there was no significant difference in 6-keto PGF1 alpha concentration in peritoneal fluid between the adenomyosis group and the leiomyoma group. TXB2 concentration did not significantly differ in the three study groups. Leukotriene C4 level in the adenomyosis group was significantly higher than that of leiomyoma in the secretory phase. Leukotriene B4 could not be detected by our assay system. Our results suggest that leukotriene C4 is possibly involved in the pathophysiology of endometriosis.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Ascitic Fluid; Endometriosis; Female; Genital Diseases, Female; Humans; Leukotriene B4; Prostaglandins; SRS-A; Thromboxane B2; Uterine Neoplasms

Products of the cyclooxygenase and lipoxygenase pathways of arachidonic acid metabolism were estimated in the cul-de-sac fluid from patients with endometriosis, pelvic adhesions and normal laparoscopic examinations, with and without chronic pelvic pain. No correlation between the symptoms, underlying diagnoses, and the concentrations of eicosanoids were observed.

Topics: 6-Ketoprostaglandin F1 alpha; Abdominal Pain; Arachidonic Acid; Arachidonic Acids; Ascitic Fluid; Chronic Disease; Dinoprostone; Eicosanoids; Endometriosis; Female; Genital Diseases, Female; Humans; Laparoscopy; Leukotriene B4; Pelvis; Tissue Adhesions

We studied the effect of ovarian cancer and its chemotherapy on the urinary excretion of prostacyclin (PGI2) and thromboxane A2 (TxA2) hydration and metabolic products. In six patients we measured 6-keto-PGF1 alpha and 2,3-dinor-6-keto-PGF1 alpha (PGI2 products) and thromboxane B2 (TxB2) and 2,3-dinor-TxB2 (TxA2 products) by HPLC followed by radioimmunoassay before, during and after the combined infusion of cisplatin, 4'epi-adriamycin and cyclophosphamide. Before the first cytostatic infusion, the urinary excretion of prostanoids was on average 4.4-5.8 times higher than in patients with ovarian endometriosis (n = 19). The infusion of cytostatics led to a 50-120% rise in the excretion of prostanoids during the first post-infusion 9 hours, but in the subsequent 10 hours their output was 25-45% below the initial value and remained low for at least 2 weeks. Following repetitive courses of cytostatics (2-4 per patient), prostanoid excretion tended to normalise. These data suggest that ovarian cancer is associated with increased production of PGI2 and TxA2, and that cytostatics suppress this production. This may be of biological significance in tumour behaviour and in the effect of cytostatics.

Topics: 6-Ketoprostaglandin F1 alpha; Adenocarcinoma; Adolescent; Adult; Aged; Antineoplastic Combined Chemotherapy Protocols; Cisplatin; Cyclophosphamide; Cystadenocarcinoma; Endometriosis; Epirubicin; Female; Humans; Middle Aged; Ovarian Neoplasms; Thromboxane B2

Peritoneal fluid from 35 women with endometriosis and from 34 control women was aspirated at laparoscopy and analyzed. No differences in prostanoid levels were found. The peritoneal fluid volume, macrophage concentration, macrophage content, and content of activated macrophages as measured by acid phosphatase staining were all significantly elevated in the endometriosis patients. The macrophages were incubated and the medium was added to the zona-free hamster egg sperm penetration assay. This medium caused a significant decrease in the percentage of ova penetrated in this assay. It is postulated that one of the mechanisms of infertility in women with endometriosis may involve the increased number of activated macrophages and their ability to interfere with sperm-egg interaction.

Topics: 6-Ketoprostaglandin F1 alpha; Acid Phosphatase; Ascitic Fluid; Cell Count; Dinoprost; Endometriosis; Female; Humans; Ibuprofen; Infertility, Female; Laparoscopy; Macrophage Activation; Macrophages; Male; Menstrual Cycle; Prostaglandins E; Prostaglandins F; Radioimmunoassay; Sperm-Ovum Interactions; Thromboxane B2

Elevated prostaglandin (PG) levels in peritoneal fluid have been implicated as playing a role in infertility associated with endometriosis. This study was designed to measure peritoneal fluid levels of PG and other hormones that may influence PG release. Specific hormones measured included PGF2 alpha, PGE2, TxB2, 6-keto-PGF1 alpha, estrogen, progesterone, and epidermal growth factor. Peritoneal fluid volume and levels of estrogen, progesterone, and epidermal growth factor were significantly (P less than .05) increased during the secretory, as opposed to the proliferative, phase in both groups of patients, but no significant differences in these parameters were found between patients with and without endometriosis during either the proliferative or secretory phases. Although PG levels did not vary during the menstrual cycle in either group of patients, all four prostanoids were present in significantly (P less than .05) higher concentrations in patients with endometriosis as compared with patients without endometriosis. Furthermore, increased PG levels in patients with endometriosis appear to be due primarily to an increase in PG levels during the secretory phase of the cycle.

Topics: 6-Ketoprostaglandin F1 alpha; Ascitic Fluid; Dinoprost; Dinoprostone; Endometriosis; Epidermal Growth Factor; Estrogens; Female; Humans; Infertility, Female; Menstrual Cycle; Pelvic Neoplasms; Progesterone; Prostaglandins; Prostaglandins E; Prostaglandins F; Radioimmunoassay; Thromboxane B2

Peritoneal fluid levels of 6-keto-PGF1 alpha, TxB2, PGE2 and PGF2 alpha were measured in 62 infertile women undergoing coelioscopy. In 10 patients with mild endometriosis, the levels of all prostanoids were significantly enhanced as compared to control group (15 infertile patients without pelvic lesion). In 5 patients with moderate endometriosis, only PGF2 alpha exhibited a significant enhancement. The results confirmed the prostanoid component alteration of peritoneal fluid in infertile women with mild or moderate endometriosis, which however not has been found by all authors. In 6 patients with chronic salpingitis, no difference was found in prostanoid levels as compared to control group. The 26 patients with pelvic adhesions were distributed in 3 groups on the criterion of easy lysed or not adhesions. In group I (not lysed adhesions, 7 patients), no difference was found in prostanoid levels as compared to control group. In group II (mixed adhesions, 13 patients), the levels of all prostanoids, particularly 6-keto-PGF1 alpha, were significantly higher than that found in control group. In group III (easy lysed adhesions, 6 patients), the levels of 6-keto-PGF1 alpha, TxB2 and particularly PGF2 alpha were significantly enhanced as compared to control group. The results of this study suggest that prostanoids are implicated in physiopathology of endometriosis and pelvic adhesions and perhaps in mechanism of the associated infertility.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Dinoprost; Dinoprostone; Endometriosis; Female; Humans; Infertility, Female; Pelvic Inflammatory Disease; Peritoneal Cavity; Prostaglandins; Prostaglandins E; Prostaglandins F; Salpingitis; Thromboxane B2

Peritoneal fluid was collected from women undergoing investigations for infertility at laparoscopy performed during the luteal phase. The volume of fluid was recorded and concentrations of 6-keto prostaglandin F1 alpha were determined by radioimmunoassay. No difference was found in either the total amount or the concentration of 6-keto prostaglandin F1 alpha in the women with or without endometriosis. Furthermore, there was no difference in the volume of peritoneal fluid between these two groups of women. We conclude that 6-keto prostaglandin F1 alpha in peritoneal fluid is not associated with macroscopically visible endometriosis.

Topics: 6-Ketoprostaglandin F1 alpha; Ascitic Fluid; Endometriosis; Female; Humans; Infertility, Female; Laparoscopy; Radioimmunoassay; Uterine Neoplasms

To study the presence of prostaglandin F2 alpha (PGF2 alpha), prostacyclin (PGI2), and thromboxane A2 (TxA2) in the human ovary, follicular fluid samples were collected with puncture at laparoscopy in 17 women with pelvic endometriosis, 17 women with tubal occlusion and healthy ovaries, and 5 women with tubal occlusion and induced ovarian hyperstimulation between menstrual cycle days 8 and 18. The concentrations of the metabolites of PGF2 alpha, PGI2, and TxA2, i.e., 13,14-dihydro-15-keto PGF2 alpha (M-PGF2 alpha), 6-keto PGF1 alpha, and TxB2, respectively, were measured with radioimmunoassays. Each prostanoid was detected in follicular fluid, but their concentrations were unrelated to the menstrual cycle day at collection. Moreover, these concentrations were similar in various groups of patients. The data suggest that the human ovary produces PGF2 alpha, PGI2, and TxA2 in vivo and that these prostanoids, as measured from follicular fluid, may not be of primary significance in ovulation or endometriosis.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Dinoprost; Endometriosis; Epoprostenol; Female; Humans; Ovarian Follicle; Ovary; Ovulation Induction; Prostaglandins; Prostaglandins F; Thromboxane A2; Thromboxane B2

Peritoneal fluid obtained at laparoscopy from 49 women was measured for its content of prostaglandin E2 (PGE2), prostaglandin F2 alpha (PGF2 alpha), 6-keto-prostaglandin F1 alpha (6-KF), and thromboxane B2 (TxB2) by specific radioimmunoassays. In normal women (n = 10), the concentrations of prostaglandins in peritoneal fluid were (mean +/- SE): PGE2 = 0.79 +/- 0.26, PGF2 alpha = 0.60 +/- 0.18, 6-KF = 0.48 +/- 0.19, and TxB2 = 0.23 +/- 0.09 ng/ml; in women with endometriosis (n = 16): PGE2 = 1.43 +/- 0.72, PGF2 alpha = 1.52 +/- 0.59, 6-KF = 3.32 +/- 0.71, and TxB2 = 1.14 +/- 0.69 ng/ml; in women with chronic pelvic inflammatory disease and/or obstructed tubes (n = 19): PGE2 = 1.94 +/- 1.04, PGF2 alpha = 1.20 +/- 0.61, 6-KF = 1.55 +/- 0.40, and TxB2 = 0.64 +/- 0.24 ng/ml; in women with pelvic pain without any visible pathologic condition (n = 4): PGE2 = 1.11 +/- 0.66, PGF2 alpha = 0.73 +/- 0.55, 6-KF = 1.35 +/- 0.35, and TxB2 = 0.39 +/- 0.17. The mean volumes of peritoneal fluid recovered were 10 to 16 ml and were not significantly different between the groups. Except for a significantly elevated concentration of 6-KF in the peritoneal fluid of women with endometriosis compared to normal women (p = less than 0.02), the prostaglandins measured did not differ significantly between the groups of women studied. The possible significance of elevated 6-KF in the peritoneal fluid of women with endometriosis is discussed.

Topics: 6-Ketoprostaglandin F1 alpha; Adolescent; Adult; Ascitic Fluid; Chronic Disease; Dinoprost; Dinoprostone; Endometriosis; Epoprostenol; Female; Humans; Pain; Pelvic Inflammatory Disease; Pelvis; Prostaglandins; Prostaglandins E; Prostaglandins F; Thromboxane A2

To study peritoneal fluid (PF) prostaglandin (PG) in infertile women, 6-keto-PGF1 alpha (a breakdown product of prostacyclin) and thromboxane B2 (T X B2) (a metabolite of T X A2) were assayed with radio-immunoassays from PF samples collected at laparascopy from patients with endometriosis (n = 29), unexplained infertility (n = 13) and from women with normal pelvic organs (n = 25). The concentrations of 6-keto-PGF1 alpha and T X B2 in PF were increased (p less than 0.05) in endometriosis and unexplained infertility, as compared with the corresponding levels in the controls. In patients with endometriosis, both 6-keto-PGF1 alpha and T X B2 increases were related to the severity of the disease. There was no relationship between 6-keto-PGF1 alpha/T X B2 in PF, and day of menstrual cycle. It is suggested that endometriotic tissue and peritoneal macrophages may contribute to these prostanoids in PF. The smooth muscle activities of PF prostacyclin and T X A2 may be involved in infertility by interfering with tubal function.

Topics: 6-Ketoprostaglandin F1 alpha; Adult; Ascitic Fluid; Endometriosis; Female; Humans; Infertility; Male; Thromboxane B2; Thromboxanes

An anatomic basis for the infertility associated with endometriosis is often lacking. The present study measured peritoneal fluid levels of two of the stable products of prostaglandin endoperoxides (thromboxane B2 and 6-keto-prostaglandin F1 alpha) in patients with and without endometriosis. Both compounds were significantly elevated in the endometriosis group (n = 15, p less than 0.05). This suggests an increase in the peritoneal fluid levels of thromboxane A2 and prostacyclin, both of which could act on tubal smooth muscle and interfere with tubal function. Such altered tubal function might explain the phenomenon of endometriosis-induced infertility when there is no direct damage to the reproductive organs.

Topics: 6-Ketoprostaglandin F1 alpha; Ascitic Fluid; Endometriosis; Female; Humans; Infertility, Female; Prostaglandins F; Thromboxane B2; Thromboxanes