The Role of Proinflamatory Cytokines in the Development of Clinical Picture of Myoma and Adenomyosis

Abstract

The goal of research was to study the cytokine status in women with a combination of fibroids and
adenomyosis to determine their role in the course of the disease. Method 165 women with uterine myoma
and/or adenomyosis were examined. Patients were divided into 3 groups: 1-group - 75 women with a
combined form of myoma and adenomyosis, 2-group - 47 women with diffuse adenomyosis, 3-group - 43
women with uterine myoma. The study was conducted in 2017-2018, on the basis of the Tashkent Medical
Academy in the department of gynecology of the obstetric-gynecological complex No. 9 of Tashkent city.
The research method were a dynamic study of node blood flow by ultrasound with dopplerometry and an
immunological blood test. For myoma 5 mg ulipristal acetate was prescribed for treatment for 3 months for
at least 2 courses by 3 months with a 2 month break, and for adenomyosis - 2 mg dienogest for 6 months
continuously. For the combined form of myoma and adenomyosis, treatment was started with dienogest for
6 months continuously, then UPA was prescribed for 3 months.
Results: The determination of the level of pro-inflammatory cytokines in patients before treatment showed
the following results: the level of IL-1, IL-6 and TNF-? was higher in all three groups than in the control
group, and in the group with combined pathology IL-6 was 1,5 times higher than in groups with isolated
pathologies. After therapy, the decrease in the levels of IL-1, IL-6, and TNF-? was observed in all three
groups. Also the level of anti-inflammatory cytokines IL-10 and VEGF exceeded significantly the control
group, especially in the group with combined pathology, after the treatment, their level decreased significantly.
Discussion: An increase in the level of cytokines in the blood is most pronounced in combined forms of
myoma and adenomyosis compared with isolated forms of myoma and adenomyosis.