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The Journal of Clinical Endocrinology & Metabolism Vol. 85, No. 11 4387-4395
Copyright © 2000 by The Endocrine Society


Original Studies

Gonadotropin- and Cytokine-Regulated Expression of the Chemokine Interleukin 8 in the Human Preovulatory Follicle of the Menstrual Cycle1

Eva Runesson, Karin Ivarsson, Per Olof Janson and Mats Brännström

Department of Obstetrics and Gynecology, Institute for the Health of Women and Children, Göteborg University, 413 45 Göteborg, Sweden

Address correspondence and requests for reprints to: Eva Runesson, Department of Obstetrics and Gynecology, Göteborg University, Sahlgrenska University Hospital, 413 45 Göteborg, Sweden. E-mail: eva.runesson{at}medfak.gu.se


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Interleukin 8 (IL-8) is a chemotactic cytokine involved in the recruitment and activation of neutrophils as well as in cell proliferation and angiogenesis. Because these events are essential components of folliculogenesis, ovulation, and subsequent repair of the ruptured follicle, the presence and regulation of IL-8 in the human follicle of the menstrual cycle was investigated. The concentrations of IL-8 were higher in follicular fluids from dominant follicles of late follicular/ovulatory phase compared with those of midfollicular phase. IL-8 was detected in the media from cultured granulosa and theca cells, with 10-fold higher levels in the theca cell cultures. Exposure to FSH and LH increased the IL-8 secretion from granulosa cells, but no effect was seen in theca cell cultures. Estradiol and progesterone did not affect IL-8 secretion from any cell type. The cytokines IL-1{alpha} and IL-1ß, but not tumor necrosis factor {alpha}, enhanced IL-8 secretion from both cell types. IL-8 levels in cultures of granulosa-lutein cells from hyperstimulated in vitro fertilization cycles were not affected by either gonadotropins or steroids. These data provide evidence that ovarian IL-8 is gonadotropin and cytokine induced and may be involved in the hormonally regulated stages of follicular development and ovulation.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
OVULATION IS INITIATED by the midcycle rise in LH, which leads to a highly controlled degradation of the follicular wall ending in follicular rupture and extrusion of the oocyte. This ovulatory process, which spans around 38 h in the human (1), involves different modalities such as vascular alterations, increased proteolytic enzyme activity, and possibly smooth muscle contractions. Several of the mediators involved in ovulation are components of the classical inflammatory reaction, and the original hypothesis that ovulation is an inflammatory reaction (2) has later been substantiated by several reports (3).

A common phenomenon in inflammatory reactions is the gathering of leukocytes at the site of inflammation. Studies on the presence of these cells in ovarian tissue have revealed increased concentrations of some specific subsets of leukocytes in the preovulatory follicle at the time of ovulation (4, 5). A functional role of these cells in ovulation is likely, because the addition of leukocytes to in vitro perfused rat ovaries increases the LH-induced ovulation rate (6) and because depletion of circulating neutrophils in the rat decreases the ovulation rate in vivo (7).

A network of locally produced cytokines orchestrates the regulation and recruitment of the leukocytes to any inflammatory site. Several of these cytokines have been proposed to act as regulators in different processes in reproductive physiology. In ovarian physiology, interleukin 1 (IL-1), IL-2, IL-6, IL-8, tumor necrosis factor {alpha}, colony-stimulating factor-1 and granulocyte/monocyte colony-stimulating factor may be of particular significance (8, 9, 10, 11, 12). A distinct subgroup of cytokines is the chemokines, which mainly act as leukocyte chemoattractants. These chemokines and other specific chemotactic factors usually work in concert to accumulate and activate the subsets of leukocytes, appropriate for each specific tissue and condition.

Neutrophilic granulocytes, which make up ~60% of the total leukocyte pool in human peripheral blood (13), are only present in antral follicles (14) and accumulate in the theca layer of the ovulating follicle (5). Neutrophils contribute to tissue degradation by release of a panel of proteolytic and vasoactive factors, and this cell type has been proposed to be of importance in the ovulatory process. Activation of these cells in the ovary, by the preovulatory LH surge, was demonstrated in the rabbit ovary, where the levels of myeloperoxidase and neutrophil elastase increased after human CG injection (15).

One of the most potent neutrophil chemoattractants in the human is IL-8. This chemokine attracts and activates mainly neutrophils but has also some minor activity on other types of leukocytes. By its capacity to attract and activate neutrophils into sites of tissue damage, IL-8 is of considerable interest in the mechanisms of tissue degradation occurring in the follicular wall at ovulation. Previously, we and others have evaluated the presence of this chemokine in follicular fluid and granulosa-lutein cells from hyperstimulated women undergoing in vitro fertilization (IVF) (10, 16). Most of these functional studies concerning proposed intraovarian mediators in human ovulation and regulation of corpus luteum function have been carried out on fluids and cells obtained from patients undergoing gonadotropin hyperstimulation. Because this is a nonphysiological situation, results obtained in these studies may not always be in agreement with the events occurring in the normal menstrual cycle, as exemplified by the differences in prostaglandin F2{alpha} receptor regulation by luteal cells (17, 18).

The purpose of the present study was to evaluate the presence and regulation of IL-8 in follicles from the normal menstrual cycle and to compare some of the results with those of the hyperstimulated cycle.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Reagents

Estradiol and progesterone were obtained from Sigma-Aldrich Corp. GmbH (Steinheim, Germany); recombinant human FSH (rhFSH) was from Organon (Oss, The Netherlands); rhLH was from Serono (Rome, Italy); fetal bovine serum was from Life Technologies, Inc. (Paisley, UK); and recombinant IL-1{alpha}, IL-1ß, and tumor necrosis factor {alpha} were from Peprotec EC. (London, UK). The polyclonal rabbit antiserum against human IL-8 was a kind gift from Dr. R. W. Kelly (MRC Reproductive Biology Unit Center for Reproductive Biology, Edinburgh, UK). The monoclonal antihuman antibody for leukocyte common antigen (CD45) was purchased from Santa Cruz Biotechnology, Inc. (Santa Cruz, CA), and the monoclonal antihuman antibody for macrophage detection (CD 68) was from DAKO Corp. (Glostrup, Denmark).

Subjects

Tissue samples and follicular fluids for the evaluation of IL-8 in normal menstrual cycles were obtained from 28 women undergoing surgery for nonovarian diseases. Only women (mean age, 44 yr; range, 29–54) who—based on menstrual data, hormonal profiles, and intraoperative findings—were operated on during the follicular phase were included. None of the women were taking any medication known to affect the normal physiological follicular state. All women had given their informed consent before surgery, and the study was approved by the Human Research Ethics Committee at the Faculty of Medicine, Göteborg University. Serum and plasma samples were collected from each woman at the time of surgery. According to menstrual data and the levels of estradiol, LH, and progesterone in serum, the women were grouped into midfollicular phase [~ cycle days -6 to -4 in relation to predicted LH surge (day 0); estradiol, <0.6 nmol/L; LH, <8 IU/L; progesterone, <6 nmol/L], late follicular/early ovulatory phase [~ cycle days -3 to -0; estradiol, >0.6 nmol/L; LH, >8 IU/L; progesterone, <10 nmol/L], or late ovulatory phase (~ cycle days 0 to +1; LH, <8 IU/L; progesterone, >10 nmol/L]. All follicles collected were more than 9 mm in diameter, and collections from midfollicular phase were performed later than cycle day -6, to ascertain that material from the dominant follicle (19) was obtained. Follicular fluids and granulosa lutein cells (GLCs) from hyperstimulated cycles were obtained at oocyte pick-up of 13 patients (mean age, 31 yr; range, 24–37 yr) undergoing standardized controlled ovarian hyperstimulation (10) for subsequent IVF treatment in our unit.

Follicular fluid

Follicles were removed as the initial procedure during surgery, and follicular fluids were then immediately aspirated. Follicular fluids from IVF cycles were sampled at the time of aspiration at oocyte pick-up, as described previously (10). The fluid volumes were recorded, and this was followed by centrifugation at 200 x g for 10 min to remove cells, and subsequently storage of aliquots at -70 C.

Tissue isolation and cell cultures from normal menstrual cycles

After surgical removal of the follicle, it was placed in ice-chilled PBS and then immediately brought to the laboratory. Follicular fluid was aspirated from the follicle and centrifuged to collect the granulosa cells (GCs). The interior wall of the follicle was gently scraped with an operating instrument (Strabismus Hook; PMS, Tuttlingen, Germany) to further harvest the GCs, which would still be attached to the interior of the follicle in accordance with our previous experience (20). The two cell preparations were pooled, transferred to medium 199 (M199; Life Technologies, Inc.) supplemented with NaHCO3 (0.026 M) and gentamicin (50 µg/mL). Cells were then washed four times, and their viability was examined using Trypan Blue exclusion. Viability of GCs was between 50% and 60% in all samples. The theca interna cell layer was pulled away from the underlying theca externa cell layer using watchmaker’s forceps. Theca cells (TCs) were isolated after enzymatic treatment as described previously (20), but with some minor modifications. Briefly, TCs were cut into 1 x 1-mm pieces, incubated in PBS with collagenase type I (3 mg/mL; Worthington Biochemical Corp., Freehold, NJ), bovine pancreatic DNase grade II (5 µg/mL; Roche Molecular Biochemicals GmbH, Tutzing, Germany), and hyaluronidase (1 mg/mL; Sigma-Aldrich Corp. GmbH, Steinheim, Germany) for 45 min at 37 C. Every 15 min of incubation, undigested cells were mechanically separated using a Pasteur pipette. Theca cells were rinsed three times in M199, counted in a Bürker chamber, and resuspended in medium. Cell viability was determined by trypan blue exclusion and was found to be between 80% and 95% in all experiments.

GLCs from hyperstimulated cycles

GLCs from IVF patients were collected at the time of follicular aspiration and prepared for culture as described previously (10). The aspirates generally contain a considerable number of red blood cells (21), and, to obtain a purer GLC preparation, the cell suspensions were subjected to isotonic percoll centrifugation. After centrifugation, GLCs were collected and were further prepared in the same manner as for GCs of the normal cycle (see above).

Cell culture condition

GCs, TCs, and GLCs (3 x 104 cells/well) were seeded in 0.5-mL medium supplemented with fetal bovine serum (10%) on 24-well plates (Falcon; Becton Dickinson, Meylan, France) and cultured for 24 h to allow attachment of the cells. The media were then changed, and the cells were exposed to either estradiol (10 ng/mL), progesterone (10 ng/mL), rhLH (10 ng/mL), or rhFSH (10 ng/mL) for 48 or 96 h. A dose response (1, 10, and 100 ng/mL) experiment with rhFSH was performed in four GC cultures. In a subset of experiments, the cytokines IL-1{alpha}, IL-1ß, and TNF-{alpha} were added at a concentration of 3 ng/mL. At the end of each experiment, the supernatants were collected, aliquoted, and stored at -70 C until analyzed.

Immunohistochemistry

Follicles were frozen in OCT embedding medium (Tissue Tek; Miles Inc., Elkhart, IL) and stored at -70 C until used. Tissue was cut into 8-µm thick sections, placed on microscope slides (SuperFrostPlus, Menzel-Gläser, Germany), air-dried, and fixed in acetone for 5 min. Following peroxidase reduction (0.3% H2O2 in methanol, 30 min), the sections were washed with PBS, incubated with serum for 30 min, followed by IL-8 antiserum (1:500) or CD 45 antibody (1:50) at 4 C overnight. An avidin-biotin-peroxidase developing system (Vectastain ABC-kit; Vector Laboratories, Inc., Burlingame, CA) was used, with final detection by 3,3'-diaminobenzidine tetrahydrochloride (Sigma-Aldrich Corp. Gmbh) as the peroxidase substrate. The slides were counterstained with hematoxylin and mounted in Pertex (Histolab, Göteborg, Sweden). Human tonsil tissue was used as positive control tissue for IL-8 and CD 45. As a negative control, the primary antibody was substituted with an unspecific rabbit IgG (R&D, Abingdon, UK) and an unspecific mouse IgG (R&D). The specificity of the IL-8 antibody has previously been confirmed (22).

To evaluate the proportion of immune cells in the different cell cultures, the harvested GCs, TCs, and GLCs were cultured in Petri dishes for 48 h, fixed in methanol, and then stored at -20 C until analyzed. Cells were incubated with monoclonal antihuman CD 45 (common leukocyte antigen) antibody (1:50) and CD 68 (activated macrophages; 1:50) at room temperature overnight. Primary antibody binding was visualized using a biotinylated horse antimouse antibody and a streptavidin-avidin fluorescein isothiocyanate detection system (Amersham Pharmacia Biotech, Buckinghamshire, UK). Two separate experiments on each type of cell culture were evaluated.

Immunoassays

IL-8 was quantified using an enzyme-linked immunosorbent assay (R&D) that previously has been used and validated for measurements of IL-8 in follicular fluid and GLC cultures (16). According to the manufacturer, no significant cross-reactivity or interference with other cytokines was observed for the IL-8 assay, and the sensitivity was 10 pg/mL. Serum estradiol and LH were measured with a microparticle enzyme immunoassay (Abbott Laboratories, Abbott Park, IL). The sensitivities were 25 pg/mL and 0.5 IU/L, respectively. Progesterone in serum was measured with a solid phase fluoroimmunoassay (Delfia Wallac, Inc., Turku, Finland). The sensitivity was 1 nmol/L. The intra-assay variations of all assays were less than 5%, and the interassay variations were less than 10%.

Statistics

Treatments were performed in duplicates or triplicates. The data are presented as mean ± SEM. All statistical analyses were performed on absolute values. Multiple comparisons were made by one-way ANOVA, followed by Fisher’s post hoc test, and pairwise comparisons were made by paired Student’s t test. Pearson’s linear correlation was used for correlation analyses. Significance was assumed at P less than 0.05.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
IL-8 in follicular fluid and blood plasma

The levels of IL-8 in follicular fluid from dominant follicles from three different phases (midfollicular, late follicular/early ovulatory, late ovulatory) of the menstrual cycle were investigated and compared with the levels of IL-8 in blood plasma obtained at the same time. IL-8 levels in plasma were similar (mean values between 15–30 pg/mL) at the three phases. There was no difference between plasma and follicular fluid levels at midfollicular phase, whereas higher levels were found in follicular fluid than in blood plasma of late follicular/early ovulatory phase and late ovulatory phase (Fig. 1Go). Levels of IL-8 in follicular fluid from dominant follicles of late follicular/early ovulatory phase (259 ± 132 pg/mL) and late ovulatory phase (175 ± 61 pg/mL) were significantly higher than in follicular fluid from dominant follicles of midfollicular phase (34 ± 18 pg/mL)(Fig. 1Go). At the end of gonadotropin hyperstimulation for IVF, the levels of IL-8 in blood plasma (<5pg/mL) and follicular fluid (275 ± 35 pg/mL) were comparable with those of the late follicular phase of the natural cycle. A positive correlation (r = 0.50, P < 0.05) was found between follicular fluid volume and follicular fluid IL-8 levels in follicles when all three stages of the natural cycle were included (Fig. 2AGo).



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Figure 1. Concentrations of IL-8 in blood plasma ({square}) and follicular fluid ({blacksquare}) during three different stages of the follicular phase of the human menstrual cycle [MF, midfollicular phase (n = 13); LF/EO, late follicular/early ovulatory phase (n = 3); LO, late ovulatory phase (n = 6)]. Data are presented as mean ± SEM. *, P < 0.05; **, P < 0.01.

 


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Figure 2. IL-8 levels in follicular fluid; correlation with follicular fluid volume. A, Positive correlation between fluid volume and IL-8 levels when samples from all stages (midfollicular, late follicular/early ovulatory, and late ovulatory) of the natural menstrual cycle were included. B, Follicular fluid samples from two follicles of each of eight patients undergoing IVF treatment ({circ}, dotted line) were measured for volume and IL-8. No correlation existed. As a comparison, samples of the subgroup made up from the corresponding stage (late follicular phase/early ovulatory and late ovulatory phase) of the natural cycle (data points taken from A) are shown (•, solid line). No correlation existed.

 
No correlation between follicular fluid volume and IL-8 levels was found in the hyperstimulated IVF cycle (Fig. 2BGo, {circ}, dotted line). A subgroup analysis of the stages of the natural cycle that would be of comparable developmental stage (late follicular/early ovulatory and late ovulatory stage) to the IVF samples did not show any correlation (Fig. 2BGo, •, solid line).

IL-8 levels in cultures of GCs, TCs, and GLCs; effects of gonadotropins and steroids

The levels of IL-8 in the media of cultured GCs (Fig. 3Go, A and B) and TCs (Fig. 4Go, A and B) were somewhat higher after the first 48 h of culture compared with the second 48 h of culture. The levels of IL-8 were significantly increased by the presence of rFSH (10 ng/mL) in GC culture both during the first and second 48-h period (Fig. 3BGo). In all eight individual experiments, higher IL-8 levels were seen after FSH treatment compared with control. A similar effect in GCs was seen by rLH (10 ng/mL) (Fig. 3BGo), which caused increased IL-8 levels in all five cultures, although the mean value was not significantly higher than the mean value of control. The levels of IL-8 under control conditions were about 10-fold higher in cultures of TCs compared with GCs. No effect by gonadotropins was seen in the TC cultures (Fig. 4BGo). Estradiol and progesterone did not affect the IL-8 levels in the media conditioned by either of the two cell types (Figs. 3AGo and 4AGo).



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Figure 3. Effects of steroids (A) and gonadotropins (B) on IL-8 secretion by cultured GCs. GCs, cultured for a 48-h period ({square}), followed by a second period of 48 h ({blacksquare}), were treated with medium alone (C), steroids (E2, estradiol; P4, progesterone), or gonadotropins (LH and FSH). All treatments were performed with a concentration of 10 ng/mL. The results shown are mean ± SEM of five to eight experiments with duplicate treatments. *, P < 0.05; **, P < 0.01.

 


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Figure 4. Effects of steroids (A) and gonadotropins (B) on IL-8 secretion by cultured TCs. TCs, cultured for a 48-h period ({square}), followed by a second period of 48 h ({blacksquare}), were treated with medium alone (C), steroids (E2, estradiol; P4, progesterone), or gonadotropins (LH and FSH). All treatments were performed with a concentration of 10 ng/mL. The results shown are mean ± SEM of 8–10 experiments with duplicate treatments. No significant difference was observed.

 
Dose-response experiments with rFSH (1, 10, and 100 ng/mL) in GC cultures revealed maximal stimulatory effect, in three of four experiments, at 10 ng/mL after 48 h (Fig 5Go). The IL-8 levels were lower after 96 h of culture, and the maximal stimulatory effect was seen at 100 ng/mL (data not shown).



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Figure 5. IL-8 secretion by GCs in response to FSH. GCs were cultured for 48 h in medium alone ({square}) or exposed to 1 ng/mL (striped bars), 10 ng/mL (crossed bars), or 100 ng/mL ({blacksquare}) of FSH. The data from four individual experiments are presented as mean ± SEM of triplicate wells. *, P < 0.05; **, P < 0.01; ***, P < 0.001 vs. each control ({square}).

 
To further investigate the possible differences between cells of hyperstimulated and normal cycles, similar experiments were performed with GLCs. The basal IL-8 levels after 48 and 96 h of culture were 832 ± 301 pg/mL (n = 5) and 410 ± 77 pg/mL (n = 5), respectively. No effect was seen by the presence of either gonadotropins or steroids (data not shown).

Effects of proinflammatory cytokines on IL-8 secretion from GCs and TCs

The effects of the proinflammatory cytokines IL-1 and TNF-{alpha} on IL-8 secretion were tested at a cytokine concentration of 3 ng/mL, a concentration that previously has been shown to be in the range where a clear stimulation of mediator products of human GLCs was seen (11, 16).

The cytokine TNF-{alpha} (3 ng/mL) did not affect IL-8 secretion in any cell type, whereas both IL-1{alpha} (3 ng/mL) and IL-1ß (3 ng/mL) markedly enhanced IL-8 secretion in GC and TC cultures. The levels in the IL-1-stimulated cultures were ~5-fold higher than in control culture after 48 h. During the second 48-h culture period, the levels were up to 10-fold higher when compared with the control levels at that time, although the absolute levels were similar to those of the first 48-h culture (Fig. 6Go).



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Figure 6. The effect of cytokines on IL-8 production from cultured GCs (A) and TCs (B). GCs and TCs were cultured for 48 h ({square}), followed by a second 48-h period ({blacksquare}), in the presence of medium alone (C), IL-1{alpha} (3 ng/mL), IL-1ß (3 ng/mL), or TNF-{alpha} (3 ng/mL). The data are presented as mean ± SEM of five to six experiments with duplicate treatments. *, P < 0.05; **, P < 0.01.

 
Immunohistochemistry

The distribution of IL-8 and total leukocytes (CD 45+) in the dominant preovulatory follicle was investigated by immunohistochemistry. To evaluate any differences between dominant and nondominant follicle, the distribution of IL-8 and leukocytes in follicles (~5 mm) taken from women in the secretory phase of the menstrual cycle was also studied.

Positive staining for IL-8 was seen in the TC layer of preovulatory follicles, with a higher intensity localized around blood vessels. Moderate IL-8 staining could be seen in the GC layer (Fig. 7AGo). In the nondominant follicle, moderate staining for IL-8 was seen in the TC compartment, but no staining was seen in the GC layer (Fig. 7BGo). Positive staining for CD 45 was seen predominantly in the TC layer of preovulatory follicles (Fig. 7CGo), whereas very few CD 45-positive cells could be localized in small follicles (Fig. 7DGo).



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Figure 7. Sections of human follicles stained for IL-8 and CD 45. A, Preovulatory follicle displays positive IL-8 staining predominantly localized in the TC layer surrounding the blood vessels, and moderate staining in the GC layer. B, Nondominant follicle with moderate staining for IL-8 in the theca layer. C, CD 45-positive cells in the preovulatory follicle were mainly seen in the theca layer, whereas only few (D) CD 45-positive cells (arrows) were seen in the nondominant follicle. E, Unspecific IgG as negative control. Scale bars, 170 µm.

 
In the GLC cultures, CD 45-positive cells and CD 68-positive cells accounted for 11–13% and 8–15% of the total number of cells, respectively. In the GC cultures, no CD 45- or CD 68-positive cells were found, whereas the TC cultures were found to contain 3–4% of CD 45-positive cells and 2% of CD 68-positive cells.


    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Because there now exists ample evidence of leukocyte activity in the ovary during folliculogenesis and ovulation, the present study was designed to evaluate the presence and regulation of the neutrophil-attracting and -activating chemokine IL-8 in the human follicle of the menstrual cycle. Comparisons concerning the regulation and expression of IL-8 during the normal menstrual cycle and the nonphysiological hyperstimulated IVF cycle were also done.

The IL-8 levels in follicular fluid of the dominant follicle were higher than in blood plasma during late follicular/ovulatory phase, and this difference was not seen during midfollicular phase. The increased levels of IL-8 in the preovulatory follicles, compared with the follicles of midfollicular phase, were further demonstrated by the existence of a positive correlation between follicular fluid volume and follicular fluid IL-8 concentration in dominant follicles. The concentration of IL-8 in follicular fluid from late follicular/ovulatory phase of the natural cycle was comparable with those measured in follicles punctured for IVF in hyperstimulated cycles in the present study and what have been previously reported (16). Interestingly, only a small portion of the different cytokines that have been found in human follicular fluid are present in higher concentrations in this compartment compared with blood (reviewed in Ref. 23). Most of these studies have been carried out on follicular fluids from IVF patients. The results of the present study clearly show that there also exists a concentration gradient of IL-8 from the follicle to the blood in the natural cycle, further pointing out that this is a true physiological phenomenon. The higher concentration of IL-8 in follicular fluid of preovulatory follicles, compared with the follicles of midfollicular phase, is most likely due to increased IL-8 secretion by the follicular cells of this late differentiation stage. We and others (10, 16) have previously shown that the GLCs of the hyperstimulated cycle is a source of IL-8. In the present study, we present data that both GCs and TCs of the preovulatory follicle obtained from physiological cycles can secrete IL-8 in accordance with previous studies on RNA expression (10, 14). It is well known that the follicular fluids of the hyperstimulated cycle contains immune cells (24, 25), probably because the follicles are punctured at a very late stage of the ovulatory process. The immune cells produce large quantities of various cytokines, including IL-8, so that the possibility exists that follicular fluid IL-8, at least from the follicles of hyperstimulated cycles, can be derived from these cells.

The present study shows that both GCs and TCs can secrete IL-8, with the secretion from the TCs being ~10 times greater than the GC secretion. Thus, it can be assumed that the main source of IL-8 in the preovulatory follicle is cells of the theca layer. The immunohistochemical observation of the present study, with positive IL-8 staining in the theca area, and results of a recent study where both protein and messenger RNA for IL-8 were detected in the theca compartment from antral follicles (14), support this suggestion. The theca layer of the human follicle contains leukocytes with some time-dependent fluctuations in the distribution pattern of certain leukocyte subsets (5, 26). Because there is an extensive vascular network in this layer (27, 28), with ongoing redistribution of IL-8-responsive leukocytes, a high basal secretion of IL-8 from TC cultures of our study was expected. The TC preparation most likely contains theca layer-derived leukocytes and fibroblasts, with IL-8-secreting properties, and about 3–4% of CD 45-positive cells were found in the TC cultures. Therefore, a proportion of the IL-8 found in TC cultures may be due to secretion from these cells.

In the present study, the basal IL-8 secretion from cultured GCs from normal cycles was approximately one tenth of that from cultured TCs. This is in accordance with a previous study, where immunoreactive IL-8 protein and its messenger RNA were found in the granulosa layer from antral follicles, but to a lesser extent compared with the theca layer (14). Although the secretion of IL-8 from the TCs is higher than from GCs, the GCs should still be considered as a possible source of IL-8 with a physiological role, because most functions of chemokines require very low concentrations.

Because the peak in follicular fluid IL-8 concentrations was associated with late follicular/ovulatory phase follicles and because the levels of IL-8 are high in follicles of IVF cycles, it can be hypothesized that gonadotropins and/or steroids may regulate IL-8 expression. The midcycle gonadotropin surge is reflected in the follicular fluid compartment of the human follicle, and both LH and FSH in follicular fluid of large follicles are at their highest levels during this stage (29). The estradiol levels in follicular fluid rise in parallel with the development of the follicle and the acquisition of an increasing pool of GCs expressing aromatase. The peak levels of estradiol are present during late follicular phase (30), whereas progesterone levels rise in concert with and after the LH surge. The IL-8 secretion from GCs of normal cycles was found to be stimulated by FSH and most likely by LH. This stimulation by FSH was found to be dose dependent. LH did not affect the IL-8 secretion from the TCs, and neither did FSH, which was expected due to the lack of FSH-receptor expression on TCs. It seems as if the GC responsiveness to FSH, in terms of IL-8 secretion, is only present when these cells have developed under physiological conditions, because FSH did not influence IL-8 secretion from cultured GLCs of hyperstimulated cycles. The latter finding is in agreement with a previous study, where FSH did not affect IL-8 secretion from GLCs (16). One possible explanation to this difference regarding FSH responsiveness is that the FSH receptor in GLCs is down-regulated because these cells have been exposed to substantially higher FSH levels in vivo during the controlled ovarian hyperstimulation. There seems to exist some uncertainties concerning the effect of LH on regulation of IL-8 secretion in ovarian cells. Thus, human CG/LH has previously been demonstrated to stimulate IL-8 secretion by human ovarian stroma cells and GLCs (16). The results of the present study in cultured GLCs did, however, not show any LH-induced IL-8 production. Even if the effect of LH on GLCs could be expected to be negligible due to LH receptor occupancy and down regulation, any differences in the IVF stimulation protocols used could account for the discrepancies in results.

Progesterone has previously been suggested to be a negative regulator of IL-8 secretion in cultured GLCs, stromal cells, and endometrial cells (16, 31). Progesterone receptors are not present in GCs and TCs, which have not yet initiated their luteinization by LH (32, 33). The results of the present study, demonstrating a lack of progesterone influence on IL-8 secretion, are in line with this concept.

Proinflammatory cytokines are proposed to be involved in ovarian processes, and TNF-{alpha} as well as IL-1 are present in human follicular fluid (34) and stimulate ovulation in the perfused rat ovary (35, 36). These cytokines induce IL-8 secretion from immune cells as well as from several other cell types (37, 38). In the present study, we found a pronounced effect on IL-8 secretion by IL-1{alpha} and IL-1ß in both GC and TC cultures. The stimulatory effect by IL-1 on IL-8 secretion from GCs and TCs was found to be conserved during the second 48-h culture period, whereas the IL-8 levels in control cultures decreased by 50% during the second 48-h period. In contrast, there was a parallel decreased IL-8 secretion in both FSH-stimulated and control cultures of GCs. This may indicate a stimulatory effect of IL-1 on the viability of the GCs and TCs.

The effect of these cytokines on IL-8 secretion in cells from the theca compartment is most likely an effect on both TCs and other cells, such as the immune cells, residing in the theca layer. On the contrary, the effects of IL-1{alpha} and IL-1ß in GC cultures are most likely directly on the GCs because no CD 45-positive cells were seen in these cultures.

In the present study, there was no effect of the cytokine TNF-{alpha} on any cell type. Thus, selectivity in cytokine modulation of IL-8 secretion in both GCs and TCs exist. Even though IL-1 and TNF-{alpha} in most cases would similarly induce a chemokine response, there are cells, such as neural cells (39), that do not respond to TNF-{alpha}. Effects by TNF-{alpha} on ovarian steroid-producing cells may first appear at luteinization because IL-8 secretion from GLCs are reported to be induced by TNF-{alpha} (16).

The main function for IL-8 in the preovulatory follicle may be to act as a chemoattractant and activator of neutrophils. Thus, the LH surge with secondary effects on follicular IL-8 levels could contribute to the massive invasion of leukocytes to the ovulating follicle (4, 5). The ovarian-bound pool of leukocytes, of which some are specialized in tissue degradation, can in turn contribute to the inflammatory-like ovulatory process by release of proteolytic enzymes, such as plasminogen activator, kallikrein, elastase, collagenase, and also vasoactive substances. The action of IL-8 as a neutrophil chemotatic and activating factor in the mammalian ovary is supported by the findings that neutralization of IL-8 activity reduces the levels of both myeloperoxidase, an indicator of neutrophil accumulation, and neutrophil elastase, an indicator of neutrophil activity, in the rabbit ovary (15). Interestingly, these activities were not fully blocked, suggesting that IL-8 may not be the sole component in this process. Other chemokines probably act in combination with IL-8, because recruitment of leukocytes to any inflammatory tissue is in general orchestrated by several chemokines working together to accumulate the different immune cells needed. Furthermore, administration of an IL-8 antiserum led to a 30% reduction of the ovulation rate in the rabbit (15), which is similar to that caused by neutrophil depletion in the rat (7), indicating a role for IL-8 on neutrophils in mammalian ovulation.

The main hypothesis concerning IL-8 in ovarian function involves IL-8 as a potent mediator of ovulation by recruitment and activation of neutrophils. However, this chemokine could also, as shown in other tissues (40, 41), be a component involved in regulation of proliferation and angiogenesis. These two processes are important for growth of the follicle during the final stages of folliculogenesis and in the transition of the preovulatory follicle into a corpus luteum. The findings that gonadotropins induce IL-8 production in GCs but not in TCs suggests specific actions of IL-8 in the different cell layers.

It can be speculated that IL-8 function may be stage specific in the human ovary and that gonadotropin- and cytokine-induced IL-8 secretion from follicle cells could lead to different actions. The demonstration of IL-8 as a proliferative agent on endometrial stromal cells (42), and the evidence that FSH induces follicular growth through an indirect regulation of growth factor expression in GCs (43), supports the hypothesis that the FSH-induced IL-8 production from GCs found in the present study could contribute to the proliferative events occurring in the developing follicle.

At the time of ovulation, IL-8 function may mainly be as an attractant and activator of neutrophils because leukocyte invasion into the ovulating follicle is seen after administration of LH/human CG (4).

In summary, this study has revealed that the concentrations of the chemokine IL-8 are elevated in follicular fluid of late follicular/ovulatory phase follicles of the natural cycle and that GCs and TCs secrete IL-8. The differences in regulation of IL-8 secretion from the GCs and TCs by gonadotropins and cytokines indicate a stage-specific and pleiotropic IL-8 function and further suggest a role for IL-8 in follicular development and/or ovulation.


    Footnotes
 
1 Supported by grants from The Swedish Medical Research Council (Grant 11607 to M.B.), The Medical Faculty of Göteborg University, and the Research Foundations of Hjalmar Svensson and Sahlgrenska University Hospital. Back

Received December 15, 1999.

Revised June 28, 2000.

Accepted July 27, 2000.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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