Effects of dexamethasone on proliferation of autologous fibroblasts and on the immune profile in women undergoing pelvic surgery for infertility.

Dexamethasone (DEX) was administered postoperatively to six patients undergoing lysis of pelvic adhesions. During therapy the proportion of T cells among the peripheral blood lymphocytes sharply declined from 60% to 20%. Response to T- and B-cell mitogens decreased to 20% to 40% of the original response prior to surgery. DEX-containing serum had an enhancing effect on the growth of autologous fibroblasts derived from pelvic adhesions (50% more than the effect of pretreatment serum). Pure cortisol and DEX induced a similar enhanced growth. The enhancing ability of the patients' sera disappeared 48 hours after discontinuation of DEX, corresponding to the recovery of the lymphoid system. If there is any benefit in steroid treatment to prevent pelvic adhesion formation, it is apparently not via an inhibitory effect on fibroblast proliferation. Such treatment, however, clearly suppresses the immune response of the patients during the early postoperative course.