Biomedicines (Nov 2021)

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

  • Vito Cela,
  • Elisa Malacarne,
  • Maria Elena Rosa Obino,
  • Ilaria Marzi,
  • Francesca Papini,
  • Francesca Vergine,
  • Elena Pisacreta,
  • Elisa Zappelli,
  • Deborah Pietrobono,
  • Giorgia Scarfò,
  • Simona Daniele,
  • Ferdinando Franzoni,
  • Claudia Martini,
  • Paolo Giovanni Artini

DOI
https://doi.org/10.3390/biomedicines9111681
Journal volume & issue
Vol. 9, no. 11
p. 1681

Abstract

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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.

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