Effect of DMPA on IL-1 Alpha in Serum of Women with Endometrioma

Objective: To study the effect of DMPA on serum IL-1α in women with endometrioma undergoing the conservative surgery.Materials and methods:A randomized clinical trial was performed in thirty-five women with endometrioma who underwent conservative surgery in Reproductive Endocrinology and Laparoscopy clinic in Department of Obstetrics and Gynecology, Faculty of Medicine Ramathibodi Hospital. These patients were randomly assigned to one of the following treatments: group A surgery and postoperative treatment with DMPA 150 mg intramuscular or group B surgery alone. Serum IL-1α level was measured by enzyme-linked immunosorbent assay (ELISA) in both groups. Pain scores were evaluated using a visual analog scale (VAS) at 2 and 12 weeks after the operation.Results: There was no significant difference in IL-1α serum levels between both groups at 2 weeks and 12 weeks after the surgery (p = 0.06 and 0.86 respectively). There was no significant difference in pre and postoperative IL-1α level between both group (p = 0.23 and 1.00 respectively). Pain scores of both groups were significantly decreased at 2 weeks and 12 weeks after the surgery (p < 0.001). The patients in DMPA group had significantly less pain scores at 12 weeks after the surgery (p = 0.01). Conclusion: The current study demonstrated that no significant change of IL-1α serum level in women with endometrioma before and after the surgery, with or without postoperative treatment with DMPA. We found decreasing of pain score in both group after surgery and less pain score in DMPA group

Effect of simvastatin on monocyte chemoattractant protein-1 expression in endometriosis patients: a randomized controlled trial

Abstract Background Simvastatin is a promising new drug for the treatment of endometriosis. It is a cholesterol-lowering drug that acts by inhibiting HMG-CoA reductase, resulting in a decrease in mevalonate, a precursor of cholesterol and monocyte chemoattractant protein-1 (MCP-1). This study investigated the effect of pre-operative oral simvastatin administration on MCP-1 gene expression and serum MCP-1 protein levels in patients with endometriosis. Methods A prospective, randomized, controlled study was conducted at the Reproductive Endocrinology Unit of the Department of Obstetrics and Gynecology at the Faculty of Medicine Ramathibodi Hospital. Forty women (mean age: 18–45 years) scheduled for laparoscopic surgery who had been diagnosed with endometriosis were recruited and randomly assigned to either a treatment group (20 mg/d of orally administered simvastatin for 2 weeks before surgery) or an untreated control group. Serum was collected before and after treatment and protein levels of MCP-1 were determined. MCP-1 and CD68 transcript levels were also quantified using real-time PCR on endometriotic cyst tissues. Results MCP-1 gene expression on endometriotic cyst was not significantly different between the simvastatin-treated and untreated groups (P = 0.99). CD68 expression was higher in the treatment group compared to the control group, but this was not statistically significant (P = 0.055). Serum MCP-1 levels following simvastatin treatment were higher than in samples obtained before treatment (297.89 ± 70.77 and 255.51 ± 63.79 pg/ml, respectively) (P = 0.01). Conclusions Treatment with 20 mg/d of simvastatin for 2 weeks did not reduce the expression of either the chemokine MCP-1 gene or macrophage-specific genes. Cumulatively, this suggests that simvastatin is not ideal for treating endometriosis because a higher dose of simvastatin (40–100 mg/d) would be needed to achieve the target outcome, which would significantly increase the risk of myopathy in patients. Trial registration Thai Clinical Trials Registry TCTR20130627003 Registered: June 27, 2013