Evaluation of CA-125 and soluble CD-23 in patients with pelvic endometriosis: a case-control study / Avaliação do CA-125 e CD-23 solúvel em pacientes com endometriose pélvica: estudo de caso-controle

OBJECTIVE: To evaluate serum concentrations of CA-125 and soluble CD-23 and to correlate them with clinical symptoms, localization and stage of pelvic endometriosis and histological classification of the disease. METHODS: Blood samples were collected from 44 women with endometriosis and 58 without endometriosis, during the first three days (1st sample) and during the 7th, 8th and 9th day (2nd sample) of the menstrual cycle. Measurements of CA-125 and soluble CD-23 were performed by ELISA. Mann-Whitney U test was used for age, pain evaluations (visual analog scale) and biomarkers concentrations. RESULTS: Serum levels of CA125 were higher in endometriosis patients when compared to the control group during both periods of the menstrual cycle evaluated in the study. This marker was also elevated in women with chronic pelvic pain, deep dyspareunia (2nd sample), dysmenorrhea (both samples) and painful defecation during the menstrual flow (2nd sample). CA-125 concentration was higher in advanced stages of the disease in both samples and also in women with ovarian endometrioma. Concerning CD-23, no statistically significant differences were observed between groups. CONCLUSION: The concentrations of CA-125 were higher in patients with endometriosis than in patients without the disease. No significantly differences were observed for soluble CD-23 levels between groups.

OBJETIVO: Avaliar as concentrações séricas de CA-125 e CD-23 solúvel e correlacioná-los com sintomas clínicos, localização e estádio da endometriose pélvica e classificação histológica da doença. MÉTODOS: Amostras de sangue foram coletadas de 44 mulheres com endometriose e 58 sem endometriose durante os primeiros três dias (1ª amostra) e durante o sétimo, o oitavo e o nono dia (2ª amostra) do ciclo menstrual. As dosagens de CA-125 e CD-23 solúvel foram realizadas por ELISA. O teste U de Mann-Whitney foi usado para idade, avaliação de dor (escala analógica visual) e para a concentração dos biomarcadores. RESULTADOS: Os níveis séricos de CA-125 foram mais altos nas pacientes com endometriose do que no grupo-controle quando avaliados em ambos os períodos do ciclo menstrual, assim como apresentaram-se elevados nessas mulheres quando referiam dor pélvica crônica, dispareunia de profundidade (coleta na 2ª amostra), dismenorreia (ambas as amostras) e dor ao evacuar durante o fluxomenstrual (coleta na 2ª amostra). A concentração de CA-125 foi mais alta no estádio avançado em ambas as amostras, assim como em mulheres com endometriomas ovarianos. Em relação ao CD-23 solúvel, nenhuma diferença estatisticamente significativa foi observada entre os grupos. CONCLUSÃO: As concentrações de CA-125 foram mais altas em pacientes com endometriose do que em pacientes sem a doença. Nenhuma diferença estatisticamente significativa foi observada para CD-23 solúvel entre os grupos.

Changes of Serum Cytokines After the Long Term Immunotherapy with Japanese Hop Pollen Extracts

Japanese hop (Hop J) pollen has been considered as one of the major causative pollen allergens in the autumn season. We developed a new Hop J immunotherapy extract in collaboration with Allergopharma (Reinbeck, Germany) and investigated immunologic mechanisms during 3 yr immunotherapy. Twenty patients (13 asthma with rhinitis and 7 hay fever) were enrolled from Ajou University Hospital. Sera were collected before, 1 yr, and 3 yr after the immunotherapy. Changes of serum specific IgE, IgG1 , and IgG4 levels to Hop J pollen extracts and serum IL-10, IL-12, TGF-beta1 and soluble CD23 levels were monitored by ELISA. Skin reactivity and airway hyper-responsiveness to methacholine were improved during the study period. Specific IgG1 increased at 1 yr then decreased again at 3 yr, and specific IgG4 levels increased progressively (p<0.05, respectively), whereas total and specific IgE levels showed variable responses with no statistical significance. IL-10, TGF-beta1 and soluble CD23 level began to decrease during first year and then further decreased during next two years with statistical significances. (p<0.05, respectively). In con-clusion, these findings suggested the favorable effect of long term immunotherapy with Hop J pollen extracts can be explained by lowered IgE affinity and generation of specific IgG4 , which may be mediated by IL-10 and TGF-beta1.

Association of intestinal helminths with decreased liver size and sCD23 concentration during falciparum malaria.

To determine if intestinal helminths and the CD23/nitric oxide pathway had an influence on liver size, we conducted a cross-sectional study on 438 patients with confirmed P. falciparum malaria admitted at the Hospital for Tropical Diseases in Bangkok. For all patients the liver size was measured as number of centimeters below the rib cage, a stool examination was conducted, and CD23 and reactive nitrogen intermediates were measured. The median liver size was smaller in helminth-infected patients than in helminth-free patients (chi2 for trend = 9.1, p = 0.003). Liver size significantly increased with the concentration of sCD23 (p < 0.0001). The median sCD23 concentration (OD) was significantly lower in helminth-infected patients than in helminth-free patients, respectively 0.33 (quartiles 0.24-0.57) and 0.45 (quartiles 0.27-0.59), (p = 0.01). There was a negative correlation between sCD23 concentrations and RNI (Spearman's rho = -0.40, p < 0.0001). All the above results remained significant after controlling for potential confounders. These results are compatible with a CD23/NO-mediated decrease in liver size in helminth-infected patients.