The involvement of multifunctional TGF-β and related cytokines in pathogenesis of endometriosis

Immunol Lett. 2018 Sep;201:31-37. doi: 10.1016/j.imlet.2018.10.011. Epub 2018 Oct 25.


Purpose: Transforming growth factor β (TGF-β) is one of the major immune and inflammation factors responsible for regulating cell proliferation, differentiation, angiogenesis, and immune responses. Deregulated TGF-β activity, especially its influence in peritoneal cytokine cross-talk, has been implicated in pathologies of endometriosis. The aim of this study was to determine whether TGF-β could be involved in the pathogenesis of endometriosis. For this purpose, we evaluated concentrations of TGFβ1, TGF-β2, TGF-β3 and interleukin (IL)-1β, IL-6, IL-10, IL-17, IL-21 and IL-22 in peritoneal fluid (PF) and serum of women with endometriosis.

Methods: A total of 66 women of reproductive age were involved in the study, 51 endometriosis patients, and 15 women from the control group. PF and serum levels of all cytokines were measured with ELISA in women with or without endometriosis.

Results: Higher PF and serum levels of TGF-β1, TGF-β2, TGF-β3, presented also as a total TGF-β in women with endometriosis compared to control were observed. The biggest increase was measured in the case of TGF-β1. The higher levels of IL-1β, IL-6, IL-10, and IL-17 in PF and serum of endometriosis women than control was observed. Higher PF levels of studied parameters in comparison with serum levels were found.

Conclusions: In endometriosis, TGF-β could affect differentiation of T helper (Th) cells, hence produce more IL-17 and IL-10 to PF and might have an indirect influence on inflammation, which is associated with higher IL-1β and IL-6 levels. In consequent, TGF-β in peritoneal fluid may promote an environment favorable to ectopic lesion formation.

Keywords: Endometriosis; Peritoneal fluid; Serum; TGF-β; Th cytokines.

Publication types

  • Comparative Study

MeSH terms

  • Adult
  • Blood Proteins / metabolism*
  • Cellular Microenvironment
  • Cytokines / metabolism
  • Endometriosis / immunology*
  • Female
  • Humans
  • Inflammation / immunology*
  • Inflammation Mediators / metabolism
  • Peritoneum / metabolism*
  • Transforming Growth Factor beta1 / metabolism*
  • Transforming Growth Factor beta2 / metabolism*
  • Transforming Growth Factor beta3 / metabolism*
  • Up-Regulation
  • Young Adult


  • Blood Proteins
  • Cytokines
  • Inflammation Mediators
  • TGFB1 protein, human
  • TGFB2 protein, human
  • TGFB3 protein, human
  • Transforming Growth Factor beta1
  • Transforming Growth Factor beta2
  • Transforming Growth Factor beta3