Posted by Article on 4/2/2002, 11:13 am

A New Method of Treatment (Vaccinotherapy) of Patients with Endometriosis and Myoma of Uterus The most common problems in gynaecology are the hormone dependent pathologies: endometriosis and myoma of uterus. About 10% of the women in reproductive ages suffer from endometriosis. More over, among the patients suffering from infertility, endometriosis is observed in 30-40% of cases. The niduses of endometriosis are found mainly in peritoneum of hip and ovaries, forming endometriomas which appear either in the form of small superficial islands or in the form of epithelial "chocolate" cysts. Endometrioma grows and invades depending on the level of estrogens and causes dysmenorrhea, dispareunia, hip- ache and infertility. The problems in the treatments of these diseases remain unsolved in gynaecology because of their idiopathic aetiology, their variable forms and insufficiency of the applied traditional hormone therapy. The methods of immune corrections are very important in endometriosis but at the moment very little attention is paid on them. The recovery of the immune reactivates through an immune correcting therapy need a specific and adequate stimulation of the immune system. It has been noticed that when the antitumor vaccine RESAN is included in the treatment of endometriosis and tumours of uterus, effectiveness of the applied therapy rises up considerably. A mildly expressed endometriosis may be found in healthy women, in difference to the endometriosis appearing as a disease with a deep proliferous processes. The balance between these two states is controlled by the immune system which can mark out the surface antigens of the cells. A very important role in this process play the proportion of cell adhesion molecules of different classes located on the surface of cells. The epichorial growth of the endometrioma has a high risk of forming relapses and the possibility of implantation of their cells to farther places from the primary location. The invasion of these cells into different tissues shows that they have some similarities with the pre cancerous growths, benign as well as malignant tumors of ovaries and uterus. The high expression of the molecules of cellular adhesion -E- kadgerins correlates with the low histological differentiations, high risk of local invasions and metastasis. As both the tumors of uterus and endometriosis arise due to the failure in the control of proliferous processes by immune system, the application of RESAN for the correction of immune system gives considerable positive results. Next we represent a short protocol of our clinical observation of patients with endometriosis and/or myoma of uterine body who were treated by vaccine RESAN. (Published in a Journal of Immunopathology: http://iaci.ru/journal/ page: http://iaci.ru/journal/issue2/full_text/sec6ar2.pdf ) The intensity of pains arising in endometriosis and myoma of uterus were scaled in the "9 units system" of Mac Laverty. Dysmenorrhea, i. e. high disturbance in the menstrual cycle, was also marked according to it. One month after the administration of the vaccine resan, in the patients suffering from endometriosis, we found a considerable reduction in the uterus size during the bimanual examination, where as the consistency of uterus was found to be rather smooth or in certain cases with limited areas of compactions. In case of myoma of uterus with nodules of different sizes, a decrease in the sizes of nodules and the size of uterine body could be expected after the vaccination. Where as in case of genital endometriosis the positive results were even more considerable. In all the patients with endometriosis who were under our observation, we found a decrease in the size of uterine body and niduses of genital endometriosis during the ultrasound examination; in the patients with combined form of endometriosis and myoma of uterus the decrease in the sizes of interstitial, subserosal and submucousal nodules up to 15-25 mm were determined. The sizes of the uterus in all of the cases under our observation, decreased from 9-10 to 5-11 weeks (fig. 1). In 20% of the patients, after a month of vaccination a complete normalization of the given parameters was observed. In the patients with myoma uterus, the sizes of the uterus became normal and the nodules of the myomas disappeared completely, which was proved during ultrasound examination. The cystic formations of ovaries (endometriomas) of sizes up to 25 cm3 were resolved. The pain- symptom in the patients suffering from genital endometriosis and in combined forms (endometriosis and myomas of uterus) reduced from 9 down to 5-7 units (in a 9 units system). In the patients with myomas of uterus, the pain- symptom reduced from 5 to 0 units (fig.2). If the intensity of dysmenorrhea was of 3 units before the vaccination, then after a month it reduced to 1 unit in the patients with endometriosis as well as in those with combined forms (endometriosis and myoma of uterus). In the patients with myomas of uterus, intensity of dysmenorrhea reduced from 1 to 0 unit (fig.3). Clinical degradation after the vaccination was not observed in any case. The patients rather remarked reduction in edema, the pains disappeared in the estrogen- dependent organs where as the general self feelings of the patients got better in overall. The changes in the tumor marker levels were various, depending on the types of markers (fig. 4). Their average values before the vaccination were: CA-125 44.7±1.34 Unt/ml, CA-19-9 28.9±1.5 Unt/ml, CA-15-3 53.2±4.3 Unt/ml, CEA 1.29±0.38 ng/ml. The CA-19-9 level after the vaccination, in average, went up 23% (P<0.05) from the initial value during the first month but after two months it became 15% less than the initial value. The CA-125 level, in average, went down smoothly to 25% (P<0.05) from the initial value. The CA-15-3 level fell down to 38% (P<0.05) from the initial value, already in the first month after the vaccination. Where as, the CEA level after the vaccination didn't change. In overall, these changes in tumor marker levels show positive results of immunotherapy. Conclusion: the administration of the vaccine resan helped to improve general health conditions and the objective parameters in all the patients who were under our observation. After the vaccination, in comparison, the niduses of endometriosis and cystic derivations of ovaries responded better than the myoma of uterus and myomatous nodules giving good regressions.

Link: See Complete Article Online with Graphs