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High Levels of Anti-GM-CSF Antibodies in Deep Infiltrating Endometriosis

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Abstract

Endometriosis is a chronic hormono-dependent inflammatory gynecological disease. Endometriosis can be subdivided into three forms: superficial peritoneal implants, endometrioma, and deep infiltrating endometriosis (DIE). Inflammation is a typical feature of endometriosis with overproduction of prostaglandins, chemokines, and cytokines, like granulocyte-macrophage colony-stimulating factor (GM-CSF). GM-CSF is a hematopoietic growth factor and immune modulator which belongs to the group of cytokines that actively participate in inflammatory reactions. GM-CSF autoantibodies (Ab) are described in inflammatory diseases such as Crohn disease and ulcerative colitis where high concentrations of anti-GM-CSF Ab are correlated with severity, complications, and relapses. We have evaluated the presence of anti-GM-CSF Ab in the serum of 106 patients with endometriosis and 92 controls using a home-made enzyme-linked immunosorbent assay (ELISA) and correlated the results with the form and severity of the disease. We found that anti-GM-CSF Ab level is significantly increased in the sera of patients with endometriosis compared to controls and is associated with the severity of the disease especially in patients with deep endometriosis (p < 0.0001) with the highest number of lesions (p = 0.0034), including digestive involvement (p = 0.0041). We also found a correlation between these levels of anti-GM-CSF Ab and the number of lesions in DIE patients (r = 0.913). In this way, searching anti-GM-CSF Ab in endometriosis patient sera could be of value for patient follow-up and put further insight into the role of inflammation and of GM-CSF in endometriosis pathogenesis.

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Acknowledgments

The authors like to thank Dr. Sophie Candon for her ELISA protocol version and Catherine Dehoulle for her technical assistance.

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Authors and Affiliations

  1. Department of Immunology, Cochin University Hospital, APHP, Paris, France

    Laurie Toullec, Frédéric Batteux & Mohamed Jeljeli

  2. Department of Gynecology Obstetrics II and Reproductive Medicine, Cochin University Hospital, Paris, France

    Pietro Santulli & Charles Chapron

  3. INSERM U1016, Institut Cochin, Paris, France

    Frédéric Batteux, Pietro Santulli, Sandrine Chouzenoux, Mohamed Jeljeli & Charles Chapron

  4. Department of Immuno-hematology, Henri Mondor University Hospital, APHP, Créteil, France

    Laurie Toullec, Thibaut Belmondo & Sophie Hue

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  1. Laurie Toullec
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Contributions

Laurie Toullec, Frédéric Batteux, Pietro Santulli, Sandrine Chouzenoux, Mohamed Jeljeli, Thibaut Belmondo, Sophie Hüe, and Charles Chapron have substantial contributions to the conception and design, the acquisition of data, or the analysis and interpretation of data. Laurie Toullec, Sophie Hüe, Frédéric Batteux, and Charles Chapron contributed to the drafting and critically revising the article for important intellectual content. Laurie Toullec, Sophie Hüe, Frédéric Batteux, and Charles Chapron approved the final version to be published.

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Correspondence to Frédéric Batteux, Sophie Hue or Charles Chapron.

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Toullec, L., Batteux, F., Santulli, P. et al. High Levels of Anti-GM-CSF Antibodies in Deep Infiltrating Endometriosis. Reprod. Sci. 27, 211–217 (2020). https://doi.org/10.1007/s43032-019-00021-8

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  • DOI: https://doi.org/10.1007/s43032-019-00021-8

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