COMPARATIVE EFFECT OF THE CALCIUM-ANTAGONIST VERAPAMIL AND THE SYNTHETIC STEROIDS GESTRINONE AND DANAZOL ON HUMAN MONOCYTE PHAGOCYTOSIS IN-VITRO

Recent evidence suggested that periovulatory treatment with an immunom odulatory agent such as verapamil might be an effective alternative to conventional treatment for endometriosis-associated subfertility. In particular, it has been reported that the drug might reduce the accent uated macrophage peritoneal activation demonstrated in patients with e ndometriosis. In this study, we compared the effect of the calcium ant agonist verapamil with those of gestrinone, danazol and testosterone o n human monocyte phagocytosis in an attempt to evaluate any significan t differences in their ability to influence a parameter of cell inflam matory activation. Peripheral blood monocytes were isolated from 37 he althy women. Monocyte function was determined by phagocytosis of fluor escent microspheres after an overnight incubation in the presence or a bsence of the various agents. This study indicates that verapamil al t he pharmacological concentration of 0.4 mu g/ml, the systemic level in patients taking 40-80 mg/8 h.p.o., significantly inhibits monocyte fu nction. A lower immunosuppressive but still significant effect was ach ieved ill this assay system with gestrinone at a concentration of 3 x 10(-8) M). The pharmacological concentration of danazol (10(-6) M) and the physiologic concentration of testosterone (10(-8) M) did not sign ificantly affect this immunologic test system. These results provide e vidence that verapamil is able to exert a slightly greater immunosuppr essive effect than steroidal drugs on monocyte phagocytosis. However, due to the small differences observed, further studies an the biologic al mechanism of the drug seem to be necessary to completely elucidate its potential role in endometriosis-associated subfertility.