{
  "abstract": "Background: Endometriosis (EM) is a common chronic inflammatory disorder affecting women. The coronavirus disease 2019 (COVID-19) pandemic may have been associated with changes in systemic inflammatory regulation.\n\nObjectives: This study aimed to measure and compare serum interleukin-6 (IL-6) levels, mRNA levels of vascular endothelial growth factor (VEGF), C-X-C motif chemokine 5 (CXCL5), and substance P (SP), as well as markers of neutrophil extracellular trap formation (NETosis), in patients with EM before and after the onset of the COVID-19 pandemic.\n\nMethods: We used data from the Tehran Lipid and Glucose Study (TLGS). Among 2558 women in the TLGS, 465 had a diagnosis of endometriosis. Of these, 13 women had biobanked samples available from both the pre-pandemic (Phase 6, 2016 - 2018) and post-pandemic (Phase 7, 2021 - 2023) periods and were included as matched pairs within the same individuals. The primary exposure was the post-pandemic calendar period; individual COVID-19 infection data were not collected. Real-time PCR was used to quantify the expression of genes associated with SP (TAC1), neurokinin 1 receptor (TACR1), VEGF, and CXCL5 in peripheral blood mononuclear cells. Markers of NETosis, including neutrophil elastase (NE), myeloperoxidase (MPO), peptidyl arginine deiminase 4 (PAD4), and matrix metallopeptidase 9 (MMP9), were assessed. Serum IL-6 concentrations were measured by enzyme-linked immunosorbent assay.\n\nResults: Gene expression analysis showed no significant changes in TAC1, TACR1, VEGF, or CXCL5; all 95% confidence intervals (CIs) included unity, and the study was underpowered to detect small differences. Evaluation of NETosis-related genes in neutrophils stimulated with patient sera showed no significant differences in PAD4, MMP9, or MPO expression; however, NE expression was significantly elevated after the pandemic (fold change = 1.5; 95% CI, 1.01 to 2.25; P = 0.048). Other NETosis markers and IL-6 did not differ significantly (eg, IL-6 median paired difference, +0.58 pg/mL; 95% CI, -0.89 to +2.34 pg/mL; P = 0.750); thus, all non-significant results are inconclusive.\n\nConclusions: A preliminary signal of increased neutrophil elastase expression was observed after the pandemic, whereas other inflammatory and NETosis markers remained inconclusive. In this small investigation, the relative contributions of COVID-19 infection, vaccination, psychosocial stress, and lifestyle changes could not be disentangled. These hypothesis-generating findings require confirmation in larger, well-characterized cohorts.",
  "abstract_shown": true,
  "affiliations": [
    "Department of Immunology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran",
    "Reproductive Endocrinology Research Center, Research Institute for Endocrine Molecular Biology, Research Institute for Endocrine Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran",
    "Department of Immunology, Golestan University of Medical Sciences, Gorgan, Iran",
    "Foundation for Research and Education Excellence, Vestavia Hills, Al, USA"
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 9,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Maryam Matouri",
      "orcid": "0000-0002-3765-4345"
    },
    {
      "affs": [
        0
      ],
      "name": "Ameneh Koochaki",
      "orcid": "0000-0002-6476-0530"
    },
    {
      "affs": [
        1
      ],
      "name": "Shahla Noori Ardebili",
      "orcid": "0000-0001-8702-2592"
    },
    {
      "affs": [
        0
      ],
      "name": "Mostafa Haji Molla Hoseini",
      "orcid": "0000-0002-5669-3235"
    },
    {
      "affs": [
        1
      ],
      "name": "Marzieh Saei Ghare Naz",
      "orcid": "0000-0002-1259-2459"
    },
    {
      "affs": [
        2
      ],
      "name": "Moein Malekzadeh",
      "orcid": "0009-0009-3320-1523"
    },
    {
      "affs": [
        1
      ],
      "name": "Maryam Mousavi",
      "orcid": "0000-0002-3946-2507"
    },
    {
      "affs": [
        1,
        3
      ],
      "name": "Fahimeh Ramezani Tehrani",
      "orcid": "0000-0002-4609-065X"
    },
    {
      "affs": [
        0
      ],
      "name": "Nariman Mosaffa",
      "orcid": "0000-0003-1695-782X"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/889pybx8ev81d.bib",
  "cited_by": 0,
  "doi": "10.5812/ijem-171933",
  "fulltext_url": "https://pmc.ncbi.nlm.nih.gov/articles/PMC13744657/",
  "id": "889pybx8ev81d",
  "issns": [
    "1726-913X",
    "1726-9148"
  ],
  "landing_url": "https://doi.org/10.5812/ijem-171933",
  "language": "en",
  "licence": "CC-BY-4.0",
  "licence_label": "CC BY 4.0",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "heading",
      "Research Article"
    ],
    [
      "openalex",
      "2743|Endometriosis Research and Treatment"
    ]
  ],
  "openalex": "W7168281532",
  "pdf_url": "https://brieflands.com/journals/ijem/articles/171933.pdf",
  "pmcid": "PMC13744657",
  "pmid": "43001088",
  "published": "2026-06-23",
  "publisher": "Brieflands",
  "ris": "https://research.draconitic.com/paper/889pybx8ev81d.ris",
  "sources": [
    {
      "first_seen": "2026-11-11T12:22:09Z",
      "native_id": "PMC13744657",
      "source": "pmc",
      "url": "https://doi.org/10.5812/ijem-171933"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2743|Endometriosis Research and Treatment",
      "subfield": "reproductive-child"
    }
  ],
  "title": "Inflammatory Markers in Women with Endometriosis Before and After the COVID-19 Pandemic: A Matched Cohort Study from the Tehran Lipid and Glucose Study",
  "title_text": "Inflammatory Markers in Women with Endometriosis Before and After the COVID-19 Pandemic: A Matched Cohort Study from the Tehran Lipid and Glucose Study",
  "type": "peer-reviewed",
  "updated_at": "2026-11-12T12:21:06Z",
  "url": "https://research.draconitic.com/paper/889pybx8ev81d",
  "venue": "International Journal of Endocrinology and Metabolism",
  "versions": []
}