Adhesion of endometrial cells labeled with 111Indium-tropolonate to peritoneum: a novel in vitro model to study endometriosis.

OBJECTIVE: To evaluate, in a new original in vitro assay, putative factors that could modulate the adhesion of endometrial cells to peritoneum.
DESIGN: Prospective, controlled in vitro study.
SETTING: Academic research laboratory. PATIENT(S): Fourteen nonmenopausal women undergoing hysterectomy or laparoscopy for benign gynecologic indication. INTERVENTION(S): Endometrial cells obtained from women with regular cycles without endometriosis were labeled with 111Indium and confronted in vitro with mouse peritoneum in the presence of various cytokines and/or antiadhesive compounds. MAIN OUTCOME MEASURE(S): Radioactivity in 111Indium-labeled endometrial cells. RESULT(S): The adhesion of human endometrial cells to mouse peritoneum was increased by treatment with pro-inflammatory cytokines (interleukin IL-1beta, IL-6, TNF alpha, TGF-beta1). Whereas heparan sulfate had no effect on cell adhesion, a gel of ferric hyaluronate (Intergel) was able to counteract the pro-adhesive effect of cytokines. Interestingly, the pretreatment of peritoneum with cytokines, 24 hours before cell seeding in the presence of the ferric hyaluronate gel, restored the cytokine-promoting effect on cell adhesion. CONCLUSION(S): Proinflammatory cytokines promote the in vitro peritoneal adhesion of endometrial cells. An antiadhesive hyaluronate gel used in clinics decreases the adhesion in a dose-dependent manner and reduces cytokine bioavailability.