CHEMOTAXIS OF MACROPHAGES BY A PERITONEAL-FLUID PROTEIN IN WOMEN WITHENDOMETRIOSIS

Objective: To expand on a preliminary study comparing the chemotactic potential of peritoneal fluid (PF) from women with and without endomet riosis and to characterize this activity via immunosuppressants and a protease. Design: Case control study. Setting: University center. Pati ent(s): Fifty-nine women with endometriosis and 44 without, undergoing laparoscopy. Intervention(s): Collection of PF, endometriotic, ovaria n, and endometrial biopsies at laparoscopy. Main Outcome Measure(s): C hemotactic activity of PF was tested via an in vitro assay alone and i n the presence of immunosuppressants cyclosporin A (CSA), FK506, rapam ycin, and type XVII-b(S-V8) protease and in media incubated with endom etriotic, ovarian, or endometrial biopsy specimens. Result(s): The PF from women with endometriosis had significantly greater chemotactic ac tivity (cells per well, mean +/- SD) than without endometriosis (142 /- 39 versus 48 +/- 17). Cyclosporin A significantly inhibited the che motactic activity of the endometriotic PF; FK506 and rapamycin did not . Incubation of media with endometriotic tissue, but not ovarian or en dometrial, for greater than or equal to 7 hours displayed chemotactic activity. Protease type XVII-b(S-V8) added to endometriotic PF inhibit ed this chemotactic activity. Conclusion(s): Peritoneal fluid from pat ients with endometriosis contains a protein chemotactic factor attract ing inflammatory cells into the peritoneal cavity, possibly secreted b y endometriotic implants. This chemotactic factor may be a member of t he immunophilin family because of its inhibition profile. (C) 1997 by American Society for Reproductive Medicine.