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

Objective: To examine changes in local cytokine production in the eutopic endometrium of adenomyosis after treatment with medroxyprogesterone acetate (MPA) and danazol. Design: Prospective cohort study. Setting: Tertiary 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. ? 2006 American Society for Reproductive Medicine.