A profile of autoantibodies to steroid hormones and steroidogenic enzymes in women with endometriosis

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Resumo

Endometriosis is a chronic inflammatory disease that affects women of reproductive age and is characterized by the presence of a wide range of autoantibodies, including those directed against steroid hormones. Of particular scientific interest is the detection of autoantibodies to steroidogenic enzymes, which have been identified as a risk factor for premature ovarian insufficiency (POI).

Objective: To study the profile of autoantibodies to steroid and gonadotropic hormones, and steroidogenic enzymes, in women with endometriosis.

Materials and methods: Using enzyme immunoassay, serum antibodies to estradiol, progesterone, follicle-stimulating hormone, and steroidogenic enzymes (21-hydroxylase, aromatase, cholesterol side-chain cleavage enzyme) were determined in patients with ovarian and deep infiltrating endometriosis (n=45) and in women without endometriosis (n=20).

Results: In patients with endometriosis, in addition to the predominant antibodies to estradiol and progesterone (60% and 55.6%, respectively), antibodies (M and G) to steroidogenic enzymes were detected. The detection rate and odds of detecting these antibodies were higher (33.3%, OR=9.5) than those in the control group (5%). Combinations of several antibodies against enzymes were observed in patients with severe endometriosis.

Conclusion: In addition to the high prevalence of autoantibodies to steroid hormones, patients with endometriosis are highly likely to have antibodies to steroidogenic enzymes. The latter may contribute to the development of autoimmune POI and infertility. The study will continue with a larger sample size and broader range of laboratory and instrumental parameters.

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Sobre autores

Irina Menzhinskaya

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Autor responsável pela correspondência
Email: i_menzinskaya@oparina4.ru

Dr. Med. Sci., Leading Researcher, Laboratory of Clinical Immunology

Rússia, 117997, Moscow, Oparin str., 4

Stanislav Pavlovich

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation; Perinatology and Reproductology, Institute of Vocational Education, I.M. Sechenov First Moscow State Medical University, Ministry of Health of Russia

Email: s_pavlovich@oparina4.ru

PhD, Scientific Secretary, Professor, Department of Obstetrics, Gynecology, Perinatology and Reproductology

Rússia, 117997, Moscow, Oparin str., 4; Moscow

Arika Melkumyan

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: Dr.melkumyan@gmail.com

Obstetrician-Gynecologist

Rússia, 117997, Moscow, Oparin str., 4

Vladimir Chuprynin

Academician V.I. Kulakov National Medical Research Center for Obstetrics, Gynecology and Perinatology, Ministry of Health of the Russian Federation

Email: v_chuprynin@oparina4.ru

PhD, Head of the Department of Surgery

Rússia, 117997, Moscow, Oparin str., 4

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2. Fig. 1. Frequency of detection of autoantibodies of classes M and 6 in total to steroidogenic enzymes (CYP11A1, CYP19A1, CYP21A2), steroid (estradiol, progesterone) and gonadotropic (FSH) hormones in the blood serum of patients with endometriosis (group 1) and without endometriosis (group 2). *p<0.05 when comparing two groups

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3. Fig. 2. Correlation between the levels of serum autoantibodies of classes M and C to steroidogenic enzymes (CYP11A1, CYP19A1, CYP21A2), steroid (estradiol, progesterone) and gonadotropic (FSH) hormones in patients with endometriosis. *p<0.05

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