Nerve fibers TGF-β1 (transforming growth factor beta1) expression is related to dysmenorrhea and the laparoscopic appearance of endometriotic implants

Objective: To quantify TGFβ1 expression in nerve fibres in endometriotic lesions and to correlate it with dysmenorrhea and endometriotic implants appearance. To compare it with normal peritoneum.Design: Prospective comparative study of Immuno-Histochemical study of TGFβ1. Maximal Intensity of Marking (Int.Max), defined as the higher markage degree in the marked area within structure selected, was evaluated.Materials/Methods: Peritoneal endometriotic specimens were obtained from 36 women diagnosed with endometriosis at laparoscopy and from 9 control patients without endometriosis. According to the revised classification of endometriosis by the American Fertility Society for Reproductive Medicine, lesions were classified as "black" (n = 9; 20%), "deep" (n = 20; 44,4%) and "red" (n = 6; 13,3%). An endometrial biopsy was obtained to determine the menstrual phase. No hormonal treatment was used within the 3 months before the laparoscopy. TGFβ1 activity expression in nerve fibres was confirmed by optical microscopy. For immuno-histochemical evaluation, a monoclonal high-affinity antibody to TGFβ1 (Santa Cruz Biotechnology: # sc-146 TGFβ1(v)) was used. The computerized analysis was performed using by a SONY 3CCD DXC 950P colour camera. Dysmenorrhea pain-level was measured before laparoscopy using EuroQoL analogical linear scale. Statistical analysis was performed using Rho of Spearman, Kruskall-Wallis and Mann-Whitney test.Results: Statistically significant (p ≤ 0.05) differences in INTMMAX (Maximal Intensity Marking) TGFβ1 were found by comparing nerves in endometriotic lesions and in normal peritoneum. TGFβ1 INTMAX was higher in Red lesions (mean = 134,502 ± SE 22,9) (SE = Standard Error) and Deep endometriotic foci ( mean = 107,538 ± SE 8,74) than in Black lesions (mean = 65,944 ± SE 10,58) and normal peritoneum (mean = 53,752 ± SE 2,62). TGFβ1 INTMMAX was significantly related to dysmenorrhea (Spearman, p = 0,001) and both were related to the colour of the lesions (Kruskall-Wallis, p = 0,0001). Conclusions: TGFβ1 expression in nerve fibers of endometriotic implants is related to the implant appearance and to the severity of dysmenorrhea.Supported By: No support. Objective: To quantify TGFβ1 expression in nerve fibres in endometriotic lesions and to correlate it with dysmenorrhea and endometriotic implants appearance. To compare it with normal peritoneum. Design: Prospective comparative study of Immuno-Histochemical study of TGFβ1. Maximal Intensity of Marking (Int.Max), defined as the higher markage degree in the marked area within structure selected, was evaluated. Materials/Methods: Peritoneal endometriotic specimens were obtained from 36 women diagnosed with endometriosis at laparoscopy and from 9 control patients without endometriosis. According to the revised classification of endometriosis by the American Fertility Society for Reproductive Medicine, lesions were classified as "black" (n = 9; 20%), "deep" (n = 20; 44,4%) and "red" (n = 6; 13,3%). An endometrial biopsy was obtained to determine the menstrual phase. No hormonal treatment was used within the 3 months before the laparoscopy. TGFβ1 activity expression in nerve fibres was confirmed by optical microscopy. For immuno-histochemical evaluation, a monoclonal high-affinity antibody to TGFβ1 (Santa Cruz Biotechnology: # sc-146 TGFβ1(v)) was used. The computerized analysis was performed using by a SONY 3CCD DXC 950P colour camera. Dysmenorrhea pain-level was measured before laparoscopy using EuroQoL analogical linear scale. Statistical analysis was performed using Rho of Spearman, Kruskall-Wallis and Mann-Whitney test. Results: Statistically significant (p ≤ 0.05) differences in INTMMAX (Maximal Intensity Marking) TGFβ1 were found by comparing nerves in endometriotic lesions and in normal peritoneum. TGFβ1 INTMAX was higher in Red lesions (mean = 134,502 ± SE 22,9) (SE = Standard Error) and Deep endometriotic foci ( mean = 107,538 ± SE 8,74) than in Black lesions (mean = 65,944 ± SE 10,58) and normal peritoneum (mean = 53,752 ± SE 2,62). TGFβ1 INTMMAX was significantly related to dysmenorrhea (Spearman, p = 0,001) and both were related to the colour of the lesions (Kruskall-Wallis, p = 0,0001). Conclusions: TGFβ1 expression in nerve fibers of endometriotic implants is related to the implant appearance and to the severity of dysmenorrhea. Supported By: No support.