HEALTH OF WOMAN. 2019.1(137):105–109

Grek L. P.
SI «Dnipropetrovsk Medical Academy of the Ministry of Health of Ukraine», Dnipro

Pelvic pain is one of the most significant medical and social problems. The main pathophysiological component of chronic pelvic pain of genital endometriosis, uterine fibroids, pelvic inflammatory diseases is an abnormal inflammatory reaction, which is accompanied by an increase in the release of pain mediators, in particular pro-inflammatory cytokines, which leads to serious systemic disorders of the female body.

The objective: is to determine the effect of interleukin pro-inflammatory activity on systemic disorders in patients with chronic pelvic pain due to genital endometriosis in combination with benign hormone-dependent diseases of the genitals.

Materials and methods. The study involved 85 women with chronic pelvic pain (СРР) caused by genial endometriosis, uterine leiomyoma, endometrial hyperplasia, chronic salpingitis, and oophoritis in various combinations, 35 women made up the comparison group, without СРР. In assessing the pain syndrome, the visual analogue scale (VAS) was used, the McGill pain questionnaire (MPQ), the level of anxiety and depression were determined using the J. Taylor and Hamilton scale. The content of cytokine levels (IL-10, IL-6, TNF- α) in serum were determined by enzyme-linked immunosorbent assay. In order to study the molecular mechanisms of the development of СРР, expression of ER, PGR, Ki-67, VEGF, COX-2 in the eutopic endometrium was determined by immunohistochemistry.

Results. Correlation analysis showed the presence of strong, multidirectional modulo relationships between the pro-inflammatory cytokine activity and psycho-emotional status, the level of pain in patients of the main groups, compared with the group without pelvic pain (p < 0,001). Chronic pelvic pain is associated with impaired morphogenesis in the eutopic endometrium, which was determined by the presence of statistically significant direct correlations of COX-2 with IL-6 and TNF- α, as well as direct correlation of ER with IL-10 and IL-6, which was expressed in an increase in expression steroid hormones, proliferation, inflammatory activity and hyperplasia of the glandular epithelium.

Conclusions. The effect of the pro-inflammatory activity of the cytokine cascade on the mechanisms of formation of proliferation, inflammation and hyperplasia in the eutopic endometrium in patients with CPP, which increases cancer risk in women of reproductive age. The activity of the antinociceptive system plays an important role in maintaining the status of chronic pain syndrome and is a mechanism for the formation of behavioral, emotional disorders, anxiety and depression.

Key words: chronic pelvic pain, interleukins, morphogenesis markers, genital endometriosis.

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