Exploring Epithelial–Mesenchymal Transition Signals in Endometriosis Diagnosis and In Vitro Fertilization Outcomes

• Published in: Biomedicines 2021-11, Vol.9 (11), p.1681
• Main Authors: Cela, Vito, Malacarne, Elisa, Obino, Maria Elena Rosa, Marzi, Ilaria, Papini, Francesca, Vergine, Francesca, Pisacreta, Elena, Zappelli, Elisa, Pietrobono, Deborah, Scarfò, Giorgia, Daniele, Simona, Franzoni, Ferdinando, Martini, Claudia, Artini, Paolo Giovanni
• Format: Article
• Language: English
• Subjects: Biochemical markers; Body mass index; Cytokines; E-cadherin; Embryos; EMT; Endometriosis; Endometrium; Follicular fluid; Growth factors; Hormones; Hypoxia-inducible factor 1a; In vitro fertilization; Infertility; Inflammation; inflammatory cytokines; Interleukin 10; Interleukin 12; Interleukin 6; Interleukin 8; Mesenchyme; Microenvironments; Motility; Ovaries; Oxidative stress; Patients; Peritoneal fluid; Serum levels; Tumor necrosis factor-TNF; Vagina; Womens health
• ISSN: 2227-9059; 2227-9059
• DOI: 10.3390/biomedicines9111681

Endometriosis (EMS) pathogenesis has been related to the release of inflammatory mediators in peritoneal fluid, creating an altered microenvironment that leads to low-grade oocyte/embryos and to the reduction of implantation rates. The Epithelial–Mesenchymal Transition (EMT), an inflammation-related process, can be a further contributing factor to EMS. This study aimed to investigate, among various cytokines and EMT markers (Cadherins, TGF-β, HIF-1α), diagnostic markers of EMS and prognostic factors of in vitro fertilization (IVF) outcomes. Herein, EMS patients manifested higher serum levels of the inflammatory molecules IL-6, IL-8, and IL-12 and a decrease in the concentrations of the anti-inflammatory IL-10. Moreover, biochemical markers associated with the EMT process were more elevated in serum and follicular fluid (FF) of EMS patients than in controls. At the end, the number of good-quality embryos was inversely related to serum IL-6 and EMT markers. Interestingly, serum IL-6 and FF IL-10 concentrations differentiated EMS patients from controls. Finally, serum IL-8 and E-Cadherin levels, as well as FF IL-10, predicted positive IVF outcome with great accuracy. Our data confirm the pivotal role of inflammatory mediators (i.e., IL-6 and IL-10) in EMS pathogenesis and suggest that EMT-related markers are elevated in EMS patients and can be predictive of IVF outcome.