Decreased suppression of interleukin-6 after treatment with medroxyprogesterone acetate and danazol in endometrial stromal cells of women with adenomyosis

ObjectiveTo examine changes in local cytokine production in the eutopic endometrium of adenomyosis after treatment with medroxyprogesterone acetate (MPA) and danazol.DesignProspective cohort study.SettingTertiary university hospital.Patient(s)Twenty-four women with adenomyosis (study group) and 22 women without adenomyosis (control group).Intervention(s)Eutopic endometrium was separated into single endometrial stromal cells (ESCs), and was cultured in vitro alone, with MPA (10−7 M), or with danazol (10−7 M) for 8 days.Main Outcome Measure(s)Messenger RNA expression of interleukin (IL)-6, IL-8, and tumor necrosis factor-α in ESCs, and their concentrations in the supernatants of ESCs.Result(s)A significant decrease of IL-6 concentration in the supernatant, measured by ELISA, was found with time of ESCs cultured with MPA and danazol in the control group, but not in adenomyosis. The IL-6 mRNA in ESCs determined by real-time quantitative polymerase chain, as well as its concentration in the supernatant, was much higher in adenomyosis than that in the control group after treatment with MPA and danazol for 8 days.Conclusion(s)Medroxyprogesterone acetate and danazol appeared to have a decreased effect on the suppression of IL-6 liberated by ESCs in adenomyosis. This aberrant secretion of IL-6 might play a role in the formation of ectopic endometrial implants in adenomyosis.