The DOI matches its Crossref record; 26 of the 27 references it cites were found in a registry or an index.
Basal and stimulated secretion of cytokines by peritoneal macrophages in women with endometriosis
Open accessAbstract
Objective To evaluate basal (constitutive) and stimulated synthesis of tumor necrosis factor alpha (TNF alpha), interleukin (IL)-8, IL-10 by peritoneal macrophages (PM) in women with endometriosis.Design Peritoneal macrophages were cultured in the presence or absence of lipopolysaccharide (LPS) for 24 hours. Peritoneal fluids (PF) and PM supernatants were assayed for cytokines using ELISA.Setting Institute for the Study and Treatment of Endometriosis and university-based research laboratories.Subjects Fertile controls undergoing tubal ligation (n = 8) and women with endometriosis (n = 17).Intervention Peritoneal fluid samples were obtained at the time of diagnostic laparoscopy (endometriosis group) or laparoscopy for tubal ligation; both were performed in the midluteal phase of the cycle.Results Both basal and LPS stimulated production of TNF alpha, IL-8, and IL-10 by the PM were elevated significantly in women with endometriosis as compared with the fertile controls.Conclusions This study demonstrated that cytokines TNF alpha, IL-8, and IL-10 are synthesized at greater than normal levels by basal and stimulated PM from women with endometriosis. The levels of TNF alpha and IL-8 correlated with the levels in the PF, suggesting that PM are the principal source of these cytokines in the PF.
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“Implantation in the peritoneum is explained by a local disorder of the mechanisms that prevent adhesion. The consequence is an increased production of cytokine macrophages, including tumor necrosis factor α (TNF-α) and interleukin [55].”
From Endometriosis: Epidemiology, Classification, Pathogenesis, Treatment and Genetics (Review of Literature) (2021) · cites this paper as [55]
Citations
Cites
Interleukin-10-deficient mice develop chronic enterocolitis
Kühn, R., Löhler, J., Rennick, D. M., Rajewsky, K., & Müller, W. (1993) · Cell · doi:10.1016/0092-8674(93)80068-p · Cited by 4,248
de Waal Malefyt, R., Abrams, J., Bennett, B., Figdor, C. G., & de Vries, J. E. (1991) · The Journal of experimental medicine · doi:10.1084/jem.174.5.1209 · Cited by 3,762
Interleukin-8 as a macrophage-derived mediator of angiogenesis
Koch, A. E., Polverini, P. J., Kunkel, S. L., Harlow, L. A., DiPietro, L. A., Elner, V. M., Elner, S. G., & Strieter, R. M. (1992) · Science · doi:10.1126/science.1281554 · Cited by 2,135
Revised American Fertility Society Classification of Endometriosis: 1985
(1985) · Fertility and Sterility · doi:10.1016/s0015-0282(16)48430-x · Cited by 1,803
The Biology Of Cachectin/TNF: A Primary Mediator Of The Host Response
Beutler, B., & Cerami, A. (1989) · Annual Review of Immunology · doi:10.1146/annurev.iy.07.040189.003205 · Cited by 1,690
Cachectin and tumour necrosis factor as two sides of the same biological coin
Beutler, B., & Cerami, A. (1986) · Nature · doi:10.1038/320584a0 · Cited by 1,633
Properties and Functions of Interleukin-10
Mosman, T. R. (1994) · Advances in immunology · doi:10.1016/s0065-2776(08)60449-6 · Cited by 495
Interleukin‐1: A possible role in the infertility associated with endometriosis
Fakih, H., Baggett, B., & Holtz, G. (1988) · International Journal of Gynecology & Obstetrics · doi:10.1016/0020-7292(88)90224-x · Cited by 319
Halme, J. K., Becker, S., & Haskill, S. (1987) · American Journal of Obstetrics and Gynecology · doi:10.1016/0002-9378(87)90333-4 · Cited by 289
Interleukin-1: a possible role in the infertility associated with endometriosis
Fakih, H., Baggett, B., Holtz, G., Tsang, K.-Y., Lee, J. C., & Williamson, H. O. (1987) · Fertility and Sterility · doi:10.1016/s0015-0282(16)49993-0 · Cited by 285
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“[17] and Braun et al.”
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Downregulation of calponin 2 contributes to the quiescence of lung macrophages
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Kim, J. Y., Kim, H., Suh, C. S., Kim, S. H., Choi, Y. M., & Kim, J. G. (2007) · European Journal of Obstetrics & Gynecology and Reproductive Biology · doi:10.1016/j.ejogrb.2007.10.009 · Cited by 13
“Activated monocytes/macrophages secrete many angiogenic and other growth factors, which may promote the growth of endometrial explants and the expressions of numerous proinflammatory molecules [6,7].”
BackgroundAssociation of endometriosis with Sjögren's syndrome: Genetic insights (Review)
Zervou, M. I., Tarlatzis, B. C., Grimbizis, G., Spandidos, D. A., Niewold, T. B., & Goulielmos, G. N. (2024) · International Journal of Molecular Medicine · doi:10.3892/ijmm.2024.5344 · Cited by 17
“The strong association of endometriosis with inflammation has also been indicated by the elevated levels of the inflammatory cytokines IL‑6, IL‑10 and TNF‑ α (82) observed in the PF and peripheral blood of patients (83) (Fig 1).”
BackgroundYang, W., Jin, M., Wang, Y., Zhao, H., Wang, X., Guo, Y., Li, C., Xiao, B., Zhang, H., Fouzia, K., et al. (2024) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2024.137642 · Cited by 10
Sharma, P., Tseng, H.-H., Lee, J.-Y. L., Tsai, E., & Suen, J. (2020) · Molecular Human Reproduction · doi:10.1093/molehr/gaaa039 · Cited by 11
Peritoneal fluid concentrations of interleukin-11 in women with endometriosis
Gazvani, M. R., Bates, M. D., Vince, G. S., Christmas, S. E., Lewis-Jones, D. I., & Kingsland, C. R. (2000) · Fertility and Sterility · doi:10.1016/s0015-0282(00)01613-7 · Cited by 9
Prediction of endometriosis with serum and peritoneal fluid markers: a prospective controlled trial
Bedaiwy, M. A., Falcone, T., Goldberg, J., Attaran, M., Nelson, D., & Agarwal, A. K. (2002) · Fertility and Sterility · doi:10.1016/s0015-0282(01)03024-2 · Cited by 9
Pentoxifylline versus medical therapies for subfertile women with endometriosis
Lv, D., Song, H., Li, Y.-L., & Clarke, J. (2009) · Cochrane Database of Systematic Reviews · doi:10.1002/14651858.cd007677 · Cited by 10
Wójtowicz, M. K., Zdun, D., Owczarek, A. J., Skrzypulec‐Plinta, V., & Olszanecka‐Glinianowicz, M. (2025) · International Journal of Molecular Sciences · doi:10.3390/ijms26115117 · Cited by 8
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Genetic factors involved in the co‑occurrence of endometriosis with ankylosing spondylitis (Review)
Zervou, M. I., Papageorgiou, L., Vlachakis, D., Spandidos, D. A., Eliopoulos, E., & Goulielmos, G. N. (2023) · Molecular Medicine Reports · doi:10.3892/mmr.2023.12983 · Cited by 8
“In particular, elevated levels of pro‑inflammatory cytokines, including il‑6, il‑8 and TnF‑α have been detected in women with endometriosis compared to those without this condition; however, it remains unknown whether endometriosis causes this altered peritoneal microenvironment or whether it can be considered as a co…”
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Antibodies toChlamydia trachomatisin serum and peritoneal fluid of women with endometriosis
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“There is a considerable body of evidence suggesting that macrophages and NK cells as well as PGE2 and cytokines, TNF-a, ICAM-1, IL-1, IL-6, IL-8 and IL-10 are all involved in the pathogenesis of endometriosis (Mori et al., 1991; Punnonen et al., 1996; Rana et al., 1996; Bulun et al., 2000; Iwabe et al., 2000; Vigano e…”
BackgroundDmowski, W. P., Rana, N., & Jafari, N. (2001) · The Journal of the American Association of Gynecologic Laparoscopists · doi:10.1016/s1074-3804(05)60569-5 · Cited by 8
The involvement of peritoneal GATA6+ macrophages in the pathogenesis of endometriosis
Shi, M., MacLean, J. A., & Hayashi, K. (2024) · Frontiers in Immunology · doi:10.3389/fimmu.2024.1396000 · Cited by 7
Calcium‐binding protein expression in peritoneal endometriosis‐associated nerve fibres
Barcena, M. L., Münch, S., Arnold, J., Helbig, S., Schneider, A., & Mechsner, S. (2013) · European Journal of Pain · doi:10.1002/j.1532-2149.2013.00323.x · Cited by 7
“Alterations of the peritoneal environment might be promoted by factors in the peritoneal fluid, since the peritoneal fluid of women with endometriosis contains increased concentrations of pro-inflammatory cytokines (Fakih et al., 1987; Rana et al., 1996), prostaglandins (Vernon et al.”
BackgroundEndometriosis and Infertility: A Systematic Review
Harris, A., & Tsaltas, J. (2017) · Journal of Endometriosis and Pelvic Pain Disorders · doi:10.5301/jeppd.5000296 · Cited by 7
“The evidence for inflammatory changes in endometriosis affecting peritoneal fluid includes: proliferation of macrophages and phagocytic dysfunction (8-10), release of pro-inflammatory and angiogenic factors (11) and an increase AbstRAct”
BackgroundCombinatory effects of current regimens and Guizhi Fuling Wan on the development of endometriosis
Chen, C., Huang, C., Shiu, L., Yu, Y.-C., Lai, J.-C., Chang, C., Fu, C., & Huang, S.-T. J. (2022) · Taiwanese Journal of Obstetrics and Gynecology · doi:10.1016/j.tjog.2021.11.013 · Cited by 7
The Nexus of Iron, Senescence, and Fibrosis in Endometriosis: A Narrative Review
Patel, R., Kalthur, G., Datta, R., Shah, S., & Dutta, R. (2025) · Reproductive Sciences · doi:10.1007/s43032-025-01999-0 · Cited by 6
“Peritoneal fluid analysis consistently reveals an increased number and activation state of macrophages [64].”
A protocol for creating endometriosis in rhesus macaques (Macaca mulatta)
Slayden, O. D., Luo, F., & Martin, L. D. (2023) · Journal of Medical Primatology · doi:10.1111/jmp.12681 · Cited by 6
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Heinig, J., von Otte, S., Greb, R. R., & Kiesel, L. (2002) · Gynecological Endocrinology · doi:10.1080/gye.16.6.493.504 · Cited by 6
Vassiliadis, S. (2010) · Journal of Endometriosis and Pelvic Pain Disorders · doi:10.1177/228402651000200103 · Cited by 6
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BackgroundMerhi, Z. O., Emdin, D., Bosman, L., Incledon, T., & Smith, A. H. (2023) · American Journal of Reproductive Immunology · doi:10.1111/aji.13690 · Cited by 6
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Kurt, R. K., Dogan, A. C., Yeşilyurt, H., Karateke, A., & Okyay, A. G. (2014) · Clinical and Experimental Obstetrics & Gynecology · doi:10.12891/ceog17572014 · Cited by 5
Francisco, D. D. O., Andres, M. P., Gueuvoghlanian‐Silva, B. Y., Podgaec, S., & Fridman, C. (2017) · Journal of Assisted Reproduction and Genetics · doi:10.1007/s10815-017-0936-0 · Cited by 5
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Noda, T., Murakami, T., Terada, Y., Yaegashi, N., & Okamura, K. (2003) · American Journal of Reproductive Immunology · doi:10.1034/j.1600-0897.2003.00104.x · Cited by 5
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Mueller, M. D., & Taylor, R. N. (2001) · Birkhäuser Boston eBooks · doi:10.1007/978-1-4612-0213-4_13 · Cited by 4
Endometriosis and Infertility: New Concepts
Ryan, I. P., & Taylor, R. N. (1999) · Obstetrical & Gynecological Survey · doi:10.1097/00006254-199911001-00030 · Cited by 4
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Brosens, I. A., & Benagiano, G. (2011) · Wiley eBooks · doi:10.1002/9781444398519.ch1 · Cited by 7
Harvey, M. E., Shi, M., Oh, Y. S., Mitchell, D. A., Slayden, O. D., MacLean, J. A., & Hayashi, K. (2025) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2025.01.23.634555 · Cited by 4
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Young, A. N., Maghsoudlou, P., King, L. P., Rogers, M. S., & Hornstein, M. D. (2024) · Current Obstetrics and Gynecology Reports · doi:10.1007/s13669-024-00373-2 · Cited by 3
“Patients with endo-metriosis secrete higher levels of pro-angiogenic factors, such as tumor necrosis factor-alpha (TNF-α) and VEGF, and cytokines, such as interleukin (IL)-8, IL-10, IL-6, macrophage-derived growth factor, and macrophage colony-stimulating factor [66–70].”
Immunological Aspects of Endometriosis
Kanzaki, H., Nakajima, T., & Yoshimura, T. (1999) · Journal SOGC · doi:10.1016/s0849-5831(16)31084-9 · Cited by 3
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Humphries, J. E., Corr, B., Alexander, H. D., McConnell, J., Bell, A. L., Markey, G. M., & Morris, T. C. M. (1999) · British Journal of Haematology · doi:10.1111/j.1365-2141.1999.1368h.x · Cited by 3
“…et al, 1996) and peritoneal macrophages from normal peritoneal cavities, women with endometriosis or from ascitic fluid of patients with portal hypertension (Rana et al, 1996); PHA was the only stimulant causing a significant increase overall above unstimulated cells (P <0·05 Mann-Whitney U test).”
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Brown, D., Pejovic, T. B., & Nezhat, F. R. (2013) · Cambridge University Press eBooks · doi:10.1017/cbo9781139003254.015 · Cited by 3
Diagnostic Performance of Neutrophil/Lymphocyte Ratio and Platelet/Lymphocyte Ratio in Endometrioma
Aydın, D. (2019) · Istanbul Medical Journal · doi:10.4274/imj.galenos.2018.53386 · Cited by 3
Inflammation and Endometriosis
Hornung, D., & von Wussow, U. (2011) · doi:10.1002/9781444398519.ch24 · Cited by 3
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Greb, R. R., Loebbecke, K. C., Paletta, J. R. J., & Kiesel, L. (2002) · Der Gynäkologe · doi:10.1007/s00129-002-1177-5 · Cited by 3
Damario, M. A., & Rock, J. A. (2000) · Springer eBooks · doi:10.1007/978-1-4612-1194-5_22 · Cited by 3
Complications of deep infiltrative endometriosis of gastrointestinal tract
Popov, А. А., Пучков, К. В., Troshina, V. V., Sopova, Y. I., Fedorov, А. А., Tyurina, S. S., Ovsiannikova, M. R., Ershova, I. Y., & Mamedova, S. G. (2024) · V F Snegirev Archives of Obstetrics and Gynecology · doi:10.17816/aog629130 · Cited by 2
Gürgan, T., & Bektaş, G. (2023) · Elsevier eBooks · doi:10.1016/b978-0-323-89907-9.00014-4 · Cited by 2
Nowak, N. (2008) · Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver · doi:10.17169/refubium-12324 · Cited by 2
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Deo, S., Jaiswar, S., Shankhwar, P. L., Iqbal, B., & Jhirwar, M. (2017) · SSR Institute of International Journal of Life Sciences · doi:10.21276/ijlssr.2017.3.5.18 · Cited by 1
Markin, L. B., & Semenyna, H. (2024) · Lviv clinical bulletin · doi:10.25040/lkv2024.02.008 · Cited by 1
The crucial component(s) of Guizhi Fuling Wan in inhibiting endometriosis development
Chen, C., Huang, C., Yu, Y.-C., Shiu, L., Chang, C., Chou, Y.-T., & Huang, S.-T. J. (2024) · Journal of Ethnopharmacology · doi:10.1016/j.jep.2024.119067 · Cited by 1
Sirotkin, A. V., Fabová, Z., Loncová, B., Harrath, A. H., Alzuri, S. E., Montiel, M. B., & Fuchsová, B. (2025) · Theriogenology · doi:10.1016/j.theriogenology.2025.117520 · Cited by 1
Chapter 10 Endometriosis and Autoimmunity
Pasoto, S. G., Abrão, M. S., Podgaec, S., & Bonfá, E. (2008) · Technical report · doi:10.1016/s1571-5078(07)00210-3
Immunological aspects of endometriosis
de Flandre, H. J. (1996)
The role of the sympathetic nervous system and semaphorins in the pathogenesis of endometriosis
Scheerer, C. (2016) · Universitätsbibliothek der FU Berlin Hochschulschriftenstelle u. Dokumentenserver · doi:10.17169/refubium-10823
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Varughese, E. E. (2016) · University Library - University of Saskatchewan (University of Saskatchewan)
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Humphries, Corr, Alexander, McConnell, Bell, Markey, & Morris (1999) · British Journal of Haematology · doi:10.1046/j.1365-2141.1999.1368h.x
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Thiam, C. A., Bing, C. H., & Antoine, M. M. L. K. (2021) · International Journal of Clinical Obstetrics and Gynaecology · doi:10.33545/gynae.2021.v5.i3a.901
“In women diagnosed with this disease, examination of the peritoneal fluid demonstrates an alarming increase in the presence of activated macrophages and alterations in cytokine/chemokine profiles ([25]).”
BackgroundVillar’s Nodule with Multifocal Endometriosis: Case Report
(2023) · Journal of Gynecology & Reproductive Medicine · doi:10.33140/jgrm.07.01.05
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Dura, J., Ciechanowicz, J., Ciechanowicz, S., Gutowska, M., Kupidłowski, P., Nowacka, A., Perzanowska, A., Przybylska, A., Tomaszewska, Z., & Zielińska, A. (2025) · International Journal of Innovative Technologies in Social Science · doi:10.31435/ijitss.3(47).2025.3489
Mantha, K. B., & Gajendran, M. K. (2025) · Frontiers in Medicine · doi:10.3389/fmed.2025.1538368
NEZHAT, C. R., Nezhat, F. R., NEZHAT, C. R., Lakhi, N. A., & Nezhat, A. A. (2025) · Cambridge University Press eBooks · doi:10.1017/9781108561440.013
Huang, Q., Chen, J., Yang, H., Wan, Y., Ma, X., & Song, Y. (2026) · Journal of Reproductive Immunology · doi:10.1016/j.jri.2026.104859
Nahdi, S., Arafah, M., Petraglia, F., Jalouli, M., Alamri, A. M., Alanazi, M. A., Rahman, A., Alwasel, S. H., & Harrath, A. H. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27104598 · Cited by 1
“Interestingly, macrophages are thought to be the principal source of IL-6 in the peritoneal fluid [31–33].”
Metadata
- Authors
- Rana, N., Braun, D. P., House, R., Gebel, H., Rotman, C., & Dmowski, W. P.
- Affiliations
- Rush University Medical Center (US)
- ORCID
- Gebel, Howard
- Venue
- Fertility and Sterility
- Publisher
- Elsevier BV
- Published
- 1996-05
- Volume
- 65
- Issue
- 5
- Pages
- 925-930
- ISSN
- 0015-0282 (ISSN-L)
- OpenAlex
- W98713221
- Cited by
- 264
- References
- 27
- Citations by year
- 2026: 2 · 2025: 8 · 2024: 12 · 2023: 9 · 2022: 5 · 2021: 8 · 2020: 6 · 2019: 5 · 2018: 6 · 2017: 9 · 2016: 6 · 2015: 4 · 2014: 4 · 2013: 8 · 2012: 9
- FWCI
- 11.33
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Fertility and Sterility (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5r01ca058922-03)
- National Cancer Institute (CA 58922)
- Topics
- Health Sciences › Medicine › Reproductive Medicine › Endometriosis Research and Treatment
- Life Sciences › Immunology and Microbiology › Immunology › Reproductive System and Pregnancy
- Health Sciences › Medicine › Infectious Diseases › Diagnosis and treatment of tuberculosis
- Keywords
- endometriosis, peritoneal macrophages, cytokine production, TNF-α, interleukin-8, IL-10, lipopolysaccharide stimulation, peritoneal fluid
- MeSH terms
- Ascitic Fluid, Cells, Cultured, Endometriosis, Female, Humans, Lipopolysaccharides, Tumor Necrosis Factor-alpha, Cytokines, Interleukin-8, Interleukin-10, Macrophages, Peritoneal
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