Cytokine profile and oxidative stress parameters in women with initial manifestations of pelvic venous insufficiency

Abstract

Pelvic venous insufficiency (PVI) in women is widespread and is closely associated with the risk of reproductive disorders (in 15–25% of patients) and a high rate of the disease recurrence after treatment. The factors involved in venous wall damage include atherogenic stimuli and chronic endotoxin aggression due to inflammatory processes. The changes in the initial stages of the disease are usually minor and selective. There is currently an urgent need to identify initial markers of these changes to develop preventive measures for their correction. Therefore, the aim of this study was to determine the cytokine profile parameters' levels, as well as the activity of lipid peroxidation (LPO) and antioxidant defense (AOD) reactions in women with initial manifestations of PVI. Thirty-nine female patients with PVI (mean age 37.4 ± 9.1 years old) were the subjects of the study. The diagnosis was verified by clinical and instrumental examination including ultrasound angioscanning of the pelvic veins and therapeutic and diagnostic laparoscopy, and it was finally confirmed histologically. The control group included 30 nearly healthy women (mean age 33.5 ± 6.3 years old) who underwent surgical sterilization by laparoscopic access. Spectrophotometric, fluorometric and immunoassay methods were used in the study. The cytokine profile in female patients with PVI, as compared to the control group, was characterized by an increased concentration of proinflammatory (interleukin (IL) (IL-6) and IL-8) and anti-inflammatory cytokines (IL-4 and IL-10) and higher ratio values (IL-6/IL-10). The level of primary LPO products, conjugated dienes, was significantly increased and level of final products TBARs values was decreased in comparison to the control. The AOD system main enzyme activity, superoxide dismutase (SOD), was decreased, while the catalase activity increased. In patients with PVI, the glutathione reduced form concentration was lower than in the control group. The results of the study in women with PVI suggest negative changes in the cytokine profile and multidirectional changes in the indicators of the LPO system state in the initial stages of the disease. The control of these changes in patients with PVI should probably be an important component of preventive measures in the initial stages of the disease.