LYSOPHOSPHATIDYL CHOLINE, A CHEMOTACTIC FACTOR FOR MONOCYTES T-LYMPHOCYTES IS ELEVATED IN ENDOMETRIOSIS/

Inflammatory processes have been hypothesized to mediate some of the c linical sequelae associated with endometriosis. The peritoneal fluid ( PF) of women with endometriosis is known to contain more inflammatory cells and their associated cytokines, chemokines, and growth factors. This work provides strong evidence for oxidative stress in the PF of w omen with endometriosis. 1) The low density lipoprotein (LDL) isolated from the PF of subjects with endometriosis shows a small but detectab le increase in electrophoretic mobility compatible with mildly oxidize d LDL compared with LDL isolated from the plasma of the same subjects and PF of controls. 2) Isolated PF-LDL of endometriosis subjects is mo re readily oxidized in vitro than PF-LDL of controls, or LDL isolated from plasma. 3) Vitamin E content is significantly lower in endometrio sis PF compared with controls, and compared with plasma of women with endometriosis and controls. No difference is seen between plasma and P F of control subjects. 4) The ratio of phosphatidylcholine/lyso phosph atidylcholine (Ptd/lyso PtdCho) in the PF of endometriosis subjects is significantly lower compared with PF of controls.Taken together, thes e data provide strong evidence for a pro-oxidant environment in the pe ritoneal cavity of women with endometriosis. Lyse PtdCho, a product de rived from phospholipase A, action on peroxidized phosphatidylcholine and a potent chemotactic factor for monocytes and T-lymphocytes, is el evated in endometriosis. We hypothesize that the increased presence of lipid peroxidation products in the PF of endometriosis subjects may, at least partly, account for the recruitment of leukocytes, the increa se in macrophage activation, the secretion of monocyte-macrophage-deri ved cytokines, and the endometrial growth-promoting activity associate d with endometriosis.