SBU KANUNI SULTAN SULEYMAN TRAINING AND RESEARCH HOSPITAL Tissue IL-1β, IL-6 and IL-10 levels in women with pelvic inflammatory disease DR. NADİYE KÖROĞLU SBU KANUNI SULTAN SULEYMAN TRAINING AND RESEARCH HOSPITAL

Introduction Pelvic inflammatory disease (PID) is associated with fallopian tube inflammation, which can lead to infertility, ectopic pregnancy and chronic pelvic pain. Laboratory tests, including white blood cell (WBC) count, C- reactive protein (CRP) level may be beneficial but have a low sensitivity and are not spesific. To investigate the role of IL-1β, IL-6 and IL-10 tissue levels in the pathogenesis ,early diagnosis and the role in progression of the disease PID is a serious infection of the female reproductive system. Many women with PID present subtle or mild symptoms. Due to the wide variation in the symptoms and signs presented with PID, clinical evaluation cannot judge with certainty which patients are affected and which are not. In order to prevent the delay in diagnosis that contributes to inflammatory sequelae in the female reproductive tract, biological factors that may provide early diagnosis of PID must be identified and studied.

Center for disease control (CDC )has defined major and minor criteria: Major criteria: lower abdominal pain, uterine tenderness, tender cervical movements, adnexal tenderness Minor criteria: fever>38.3 degrees, abnormal vaginal or cervical mucopurulant discharge, abundance of leucocytes during the microscopic examination of vaginal discharge, elevated ESR, elevated CRP and incubation of one of the following microorganisms in the laboratory; Streptococcus agalactiae, E.coli, Klebsiella, N. gonorrhea , Cl.trachomatise Yanlış tanı veya tanıdaki gecikmeleri önlemek için 2 majör ve en az 1 minör kriter varlığında tanı

Materials and Method 15 patients diagnosed with PID according to CDC criteria (2 major criteria + at least 1 minor criteria) 15 patients diagnosed with tuboovarian abscess (TOA) with an adnexal mass in the ultrasonography or tomography 20 control group patients. IL-1ß, IL-6 ,IL-10 levels were studied from the 0.5ml sample obtained from the endoservix with ELISA.

Results Lökosit sayısı açısından pıd ile kontrol grubu arasında fark yok

IL-1β IL-6 IL-10 Leucocyte Neutrophil Sensitivity,% TOA PID 80 73,3 86,7 46,7 Specificity,% 100 73,7 84,2 68,4 Kontrol (n=20) PID (n=15) TOA AUC±SE P value Tissue IL-1β < 177 pg/ml ≥ 177 pg/ml 19 1 4 11 3 12 0,913±0,05 0,893±0,05 0,0001 Tissue IL-10 <150,7 pg/ml ≥ 150,7 pg/ml 2 13 0,943±0,04 0,947±0,04 Tissue IL-6 <65,9 pg/ml ≥65,9 pg/ml ıl-10 responsible for limiting inflammatory pathology and protecting the host from immune mediated damage. ıl-1b ve ıl-6 proinflamatuary cytokines are responsible for modulating the physiological functions of neutrophils. IL-6 plays an important role in response to damage by regulating leucocytes, neutrophils or CRP production.

Conclusion Cytokines modulate inflammatory and immune responses in infectious processes. Tissue IL-1β, IL-6 and IL-10 levels predicts the presence of PID and TOA with higher sensitivity compared to leucocytes, neutrophils and also may be used as a marker of response to antibiotherapy and to predict the outcome of PID ıl-10 responsible for limiting inflammatory pathology and protecting the host from immune mediated damage. ıl-1b ve ıl-6 proinflamatuary cytokines are responsible for modulating the physiological functions of neutrophils. IL-6 plays an important role in response to damage by regulating leucocytes, neutrophils or CRP production.

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