Abstract
Objectives
Mirena® has been shown to improve symptoms in women with minimal to moderate endometriosis.
The precise mechanisms for this have not been thoroughly investigated. We investigate
here one possible mechanism—alteration in the number of mast cells in the endometriotic
tissue.
Study design
Tissues (endometrial, endometriotic and normal peritoneal biopsies) prospectively
collected from twenty-eight women with laparoscopically confirmed minimal to moderate
endometriosis before and 6 months after treatment with Mirena® were processed for immunohistochemistry for ER and PR expression followed by toluidine
blue staining for mast cells. Photographs were obtained and the receptors and mast
cells identified and quantified.
Results
The mean (± SEM) age of the twenty-eight women was 31 (±7.2) (range 18–42) years.
Eight of the endometrial biopsies were in the proliferative phase and twenty in the
secretory phase. Six months after Mirena®, the number of mast cell expressed in the tissues decreased significantly in the
eutopic (P = 0.0358) and ectopic endometrium (P = 0.0220) but not in the normal peritoneum (P > 0.05). There were no ERs or PRs found in mast cells.
Conclusion
Mirena® causes a reduction in mast cell numbers in ectopic and eutopic endometrium in women
undergoing symptomatic treatment of minimal to moderate endometriosis. This reduction
could partly explain the efficacy of Mirena® in modulating pain in these women.
Keywords
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Article info
Publication history
Published online: September 20, 2011
Accepted:
September 2,
2011
Received in revised form:
August 16,
2011
Received:
April 19,
2011
Identification
Copyright
© 2011 Elsevier Ireland Ltd. Published by Elsevier Inc. All rights reserved.
