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Disrupted iron metabolism in peritoneal fluid may induce oxidative stress in the peritoneal cavity of women with endometriosis

Iwona Wertel 1,  
 
1
Department of Oncological Gynecology and Gynecology, Medical University of Lublin
2
Department of Psychiatry and Psychiatry Rehabilitation, Medical University of Lublin
KEYWORDS:
ABSTRACT:
Introduction:
Data on the possible role of peritoneal fluid free radical-mediated oxidative damage in the pathogenesis of endometriosis still remains inconsistent. The aim of the study was to determine iron metabolism markers and their influence on oxidative stress arameters in the peritoneal fluid of women with endometriosis.

Material and Methods:
110 women with endometriosis and 119 patients with benign ovarian cysts were included in the study. All visible peritoneal fluid was aspirated during laparoscopy from the anterior and posterior cul-de-sacs. under direct vision to avoid blood contamination. Haemoglobin, iron, total oxidative status, and total antioxidant status were measured using standard colourimetric kits.

Results:
Haemoglobin, iron levels, as well as total oxidative status values were significantly higher, whereas total antioxidant status values were significantly lower in the peritoneal fluid of patients with endometriosis, in comparison to the reference groups. No differences were observed in peritoneal fluid concentrations of all parameters measured in relation to the phase of the menstrual cycle.

Conclusions:
Peritoneal fluid of women with endometriosis is characterized by disrupted iron metabolism. This is most likely related to an increased number of erythrocytes in the peritoneal cavity of endometriotic women, which leads to a higher concentration of haemoglobin in this environment. Impaired iron homeostasis may have a significant influence on the pathophysiology of peritoneal endometriosis by the direct impact of haemoglobin derivatives and/or formation of the pro-inflammatory and pro-oxidative environment. Peritoneal cavity oxidative stress occurs predominantly in women in advanced stages of the disease.

 
REFERENCES (29):
1. Foyouzi N, Berkkanoglu M, Arici A, Kwintkiewicz J, Izquierdo D, Duleba AJ. Effects of oxidants and antioxidants on proliferation of endometrial stromal cells. Fertil Steril. 2004; 82: 1019–1022. https://doi.org/10.1016/j.fertnstert.2004.02.133.
2. Zeller JM, Henig I, Radwanska E, Dmowski WP. Enhancement of human monocytes and peritoneal macrophage chemiluminescence activities in women with endometriosis. Am J Reprod Immunol Microbiol. 1987; 3: 78–82. https://doi.org/10.1111/j.1600-0897.1987.tb00097.x.
3. Wang Y, Sharma RK, Falcone T, Goldberg J, Agarwal A. Importance of reactive oxygen species in the peritoneal fluid of women with endometriosis or idiopathic infertility. Fertil Steril. 1997; 68: 826–830. https://doi.org/10.1016/s0015-0282(97)00343-9.
4. Bedaiwy MA, Falcone T, Sharma RK, Goldberg JM, Attaran M, Nelson DR, et al. Prediction of endometriosis with serum and peritoneal fluid markers: a proscpective controlled trial. Hum Reprod. 2002; 17: 426–431. https://doi.org/10.1093/humrep/17.2.426.
5. Van Langendonct A, Casanas-Roux F, Donnez J. Iron overload in the peritoneal cavity of women with pelvic endometriosis. Fertil Steril. 2002; 78: 712–718. https://doi.org/10.1016/s0015-0282(02)03346-0.
6. Portz DM, Elkins TE, White R, Warren J, Adadevoh S, Randolph J. Oxygen free radicals and pelvic adhesion formation. I Blocking oxygen free radicals toxicity to prevent adhesion formation in an endometriosis model. Int J Fertil. 1991; 36: 39–42.
7. Ota H, Igarashi S, Hatazawa J, Tanaka T. Immunohistochemical assessment of superoxide dismutase expression in the endometrium in endometriosis and adenomyosis. Fertil Steril. 1999; 72: 129–134. https://doi.org/10.1016/s0015-0282(99)00152-1.
8. Liu Y, Luo L, Zhao H. Levels of lipid peroxides and superoxide dismutase in peritoneal fluid of patients with endometriosis. J Tongji Med Univ. 2001; 21: 166–167. https://doi.org/10.1007/bf02888087.
9. Szczepańska M, Koźlik J, Skrzypczak J, Mikołajczyk M. Oxidative stress may be a piece in the endometriosis puzzle. Fertil Steril. 2003; 79: 1288–1293. https://doi.org/10.1016/s0015-0282(03)00266-8.
10. Polak G, Kozioł-Montewka M, Gogacz M, Kotarski J. Total antioxidant status and activity of an extracellular superoxide dismutase in peritoneal fluid and plasma from women with unexplained infertility. Ginekol Pol. 2000; 71: 571–576.
11. Ishikawa M, Nakata T, Yaginuma Y, Nishiwaki K, Goishi K, Saitoh S. Expression of superoxide dismutase (SOD) in adenomyosis. Am J Obstet Gynecol. 1993; 169: 730–734. https://doi.org/10.1016/0002–9378(93)90653-z.
12. Campos Petean C, Ferriani RA, dos Reis RM, de Moura MD, Jordao AA Jr, Navarro PA. Lipid peroxidation and vitamin E in serum and follicular fluid of infertile women with peritoneal endometriosis submitted to controlled ovarian hyperstimulation: a pilot study. Fertil Steril. 2008; 90: 2080–2085. https://doi.org/10.1016/j.fertnstert.2007.10.072.
13. Jackson D, Craven RA, Hutson RC, Graze I, et al. Proteomic profiling identifies afamin as a potential biomarker for ovarian cancer. Clin Cancer Res. 2007; 13: 7370–7379. https://doi.org/10.1158/1078–0432.ccr-07-0747.
14. Murphy AA, Palinski W, Rankin S, Morales AJ, Parthasarathy S. Evidence for oxidatively modified lipid-protein complexes in endometrium and endometriosis. Fertil Steril. 1998; 69: 1092–1094. https://doi.org/10.1016/s0015-0282(98)00087-9.
15. Murphy AA, Palinski W, Rankin S, Morales AJ, Parthasarathy S. Macrophage scavenger receptor(s) and oxidatively modified proteins in endometriosis. Fertil Steril. 1998; 69: 1085–1091. https://doi.org/10.1016/s0015-0282(98)00088-0.
16. Seeber BE, Czech T, Buchner H, Bernhart KT, Seger C, Daxenbichler G, et al. The vitamin E-binding protein afamin is altered significantly in the peritoneal fluid of women with endometriosis. Fertil Steril. 2010; 94: 2923–2926. https://doi.org/10.1016/j.fertnstert.2010.05.008.
17. Ho HN, Wu MY, Chen SU, Chao KH, Chen CD, Yang YS. Total antioxidant status and nitric oxide do not increase in peritoneal fluids from women with endometriosis. Hum Reprod. 1997; 12: 2810–2815. https://doi.org/10.1093/humrep/12.12.2810.
18. Polak G, Kozioł-Montewka M, Gogacz M, Błaszkowska I, Kotarski J. Total antioxidant status of peritoneal fluid in infertile women. Europ J Obstet Gynecol Reprod Biol. 2001; 94: 261–263. https://doi.org/10.1016/s0301-2115(00)00352-3.
19. American Society for Reproductive Medicine. Revised American Society for Reproductive Medicine classification of endometriosis: 1996. Fertil Steril. 1997; 67: 817–821. https://doi.org/10.1016/s0015-0282(97)81391-x.
20. Sampson JA. Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol. 1927; 14: 422–469. https://doi.org/10.1016/s0002-9378(15)30003-x.
21. Defrère S, Lousse JC, González-Ramos R, Colette S, Donnez J, Van Langendonckt A. Potential involvement of iron in the pathogenesis of peritoneal endometriosis. Mol Hum Reprod. 2008; 14: 377–385. https://doi.org/10.1093/molehr/gan033.
22. Arumugam K. Endometriosis and infertility: raised iron concentration in the peritoneal fluid and its effect on acrosome reaction. Hum Reprod. 1994; 9: 1153–1157. https://doi.org/10.1093/oxfordjournals.humrep.a138649.
23. Arumugam K, Yip CY. De novo formation of adhesiones in endometriosis: the role of iron and free radical reactions. Fertil Steril. 1995; 64: 62–64.
24. Van Langendonct A, Casanas-Roux F, Eggermont J, Donnez J. Characterisation of iron deposition in endometriotic lesions induced in the nude mouse model. Hum Reprod. 2004; 6: 1265–1271. https://doi.org/10.1093/humrep/deh182.
25. Halme J, Hammond MG, Hulka JF, Raj S, Talbert LM. Retrograde menstruation in healthy women and in patients with endometriosis. Obstet Gynecol. 1984; 64: 151–154.
26. Wagener FAD, Feldman E, De Witte T, Abraham NG. Heme induces the expression of adhesion molecule ICAM-1. VCAM-1 and E selectin in vascular endothelial cells. Proc Soc Exp Biol Med. 1997; 216: 456–463. https://doi.org/10.3181/00379727-216-44197.
27. Simoni J, Simoni G, Lox CD, McGunegle DE. Feola M. Cytokines and PAF release from human monocytes and macrophages: effect of haemoglobin and contaminants. Artif Cells Blood Subsit Immobil Biotechnol. 1994; 22: 525–534. https://doi.org/10.3109/10731199409117880.
28. Piva M, Sharpe-Timms KL. Peritoneal endometriotic lesions differentially express a haptoglobin-like gene. Mol Hum Reprod. 1999; 5: 71–78. https://doi.org/10.1093/molehr/5.1.71.
29. Mier-Cabrera J, Jiménez-Zamudio L, Garcia-Latorre E, Hernández-Guerrero C. Quantitative and qualitative peritoneal immune profiles. T-cell apoptosis and oxidative stress-associated characteristics in women with minimal and mild endometriosis. BJOG. 2011; 118: 6–16. https://doi.org/10.1111/j.1471-0528.2010.02777.x.
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