Influence of a loop electrosurgical excision procedure (LEEP) on levels of cytokines in cervical secretions

J Reprod Immunol. 2015 Jun;109:74-83. doi: 10.1016/j.jri.2015.01.002. Epub 2015 Jan 30.


Over the past decade, there has been heightened interest in determining if there is an increased risk of adverse reproductive outcomes among women who had a loop electrosurgical excision procedure (LEEP) to remove cervical intraepithelial neoplasia (CIN). The objective of this exploratory study was to determine if the treatment of CIN with a LEEP is associated with changes in cervical soluble immune markers. Cervical cytokine concentrations were measured in women treated with LEEP and a control group of women who had colposcopy only and did not undergo LEEP. Cytokines were examined in cervical secretions collected in Merocel(®) sponges at study entry and at 6-month follow-up. Cytokines were measured using a Luminex 18-plex cytokine bead assay. The mean cytokine levels were not significantly changed from baseline to follow-up in either group, with the exception of TNF-α, which decreased among women who underwent a LEEP. When the mean levels of cytokines of the treated and untreated groups at baseline or follow-up were compared, cytokine levels tended to be lower in the treated group (particularly IFN-γ, IL-6, IL-8, and MCP-1). Findings from adjusted repeated measures analyses revealed no differences between the two groups with regard to changes in cytokine levels over time. Overall, women undergoing a LEEP showed few changes in the cervical microenvironment relative to untreated women. Future studies with additional cervical environment markers and larger sample sizes are needed to determine if a LEEP is associated with dysregulation of the cervical microenvironment.

Keywords: Cervical intraepithelial neoplasia (CIN); Cervical secretions; Cytokines; Loop electrosurgical excision procedure (LEEP).

Publication types

  • Clinical Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Adolescent
  • Adult
  • Cervix Uteri / metabolism*
  • Cervix Uteri / surgery*
  • Cytokines / metabolism*
  • Electrosurgery*
  • Female
  • Humans
  • Uterine Cervical Dysplasia / metabolism*
  • Uterine Cervical Dysplasia / surgery*


  • Cytokines