THE ROLE OF MONOCYTE CHEMOTACTIC PROTEIN-1 IN INTRAPERITONEAL ADHESION FORMATION

Abdomino-pelvic adhesions arise from infection, endometriosis, or peri toneal injury during surgery, and represent a significant source of mo rbidity in women of reproductive age. Monocyte chemotactic protein-1 ( MCP-1) plays a role in the chemotaxis of mononuclear cells and fibrobl asts in a murine wound repair model. To evaluate the role of MCP-1 in intraperitoneal adhesion formation, we investigated peritoneal fluid M CP-1 levels of women undergoing laparoscopy, Patients without endometr iosis were divided into two groups: normal fertile women undergoing bi lateral tubal ligation without intraperitoneal adhesions (n = 14) and women with pelvic adhesions (n = 8), Patients with endometriosis were arranged into two groups: women with (n = 17) and without (n = 17) adh esions. Peritoneal fluid MCP-1 levels were quantified using an enzyme- linked immunosorbent assay (ELISA), Peritoneal biopsy samples were imm unostained for the detection of MCP-1 protein and macrophages, and wer e also processed for the presence of MCP-1 mRNA expression. Among wome n without endometriosis, the median peritoneal fluid MCP-1 level was 1 44 pg/ml (range 54-261) in women without adhesions and was 336 pg/ml ( range 130-2494) in women with adhesions (P = 0.01), There was a signif icant correlation between adhesion scores and MCP-1 levels (r = 0.50; P = 0.018), Among women with endometriosis, peritoneal fluid MCP1 leve ls significantly correlated with the stage of the disease. The presenc e or absence of adhesions did not significantly affect the peritoneal fluid MCP-1 levels in this group of women. In summary, we have found t hat women with adhesions have elevated peritoneal fluid MCP-1 levels. However, we were not able to show an incremental effect of adhesions o n peritoneal fluid MCP-1 levels of patients with endometriosis. Thus, we conclude that factors besides the intraperitoneal adhesions contrib ute to the elevated peritoneal fluid MCP-1 levels in patients with end ometriosis.