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Ushiwaka T, Yamamoto S, Yoshii C, Hashimoto S, Tsuzuki T, Taniguchi K, Izumiya C, Kobayashi H, Maeda N. Peritoneal natural killer cell chemotaxis is decreased in women with pelvic endometriosis. Am J Reprod Immunol 2022; 88:e13556. [PMID: 35452561 DOI: 10.1111/aji.13556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2021] [Revised: 04/04/2022] [Accepted: 04/16/2022] [Indexed: 11/27/2022] Open
Abstract
PROBLEM NK cell and macrophage function are decreased in endometriosis, and the disease may involve reduced immune surveillance in the peritoneal cavity. NK cell cytotoxicity and migration ability (chemotaxis) are considered important; the former has been investigated, but the latter has not. METHOD OF STUDY We compared chemotaxis of immunocompetent cells (NK cells, macrophages, T cells) in peritoneal fluid obtained during laparoscopy in 27 women with and 13 without endometriosis. Peripheral blood NK cells were also obtained by the peripheral blood antibody beads method. Micro-cultured cells were examined by time-lapse photography, and the mean migration speed per cell was calculated as the chemotaxis. We investigated the relationship between chemotaxis and endometriosis. RESULTS NK cell chemotaxis was significantly lower in the endometriosis group. Macrophages and lymphocytes were not significantly different between the groups. During menstruation, NK cell chemotaxis decreased in both groups. Postmenstrual chemotaxis was increased significantly in women without endometriosis but remained low in women with endometriosis. The Revised-American Society for Reproductive Medicine score was not correlated with chemotaxis; in women with endometriosis, chemotaxis was decreased even at early stages. Peripheral blood NK cells showed no significant differences. CONCLUSIONS In women with endometriosis, not only cytotoxicity but also chemotaxis by NK cells in peritoneal cavity is significantly decreased, and particularly chemotaxis is decreased throughout the menstrual cycle. Therefore, antigens in retrograde menstrual blood that enters the peritoneal cavity might be left unprocessed. Repetition of this immune process in the peritoneal cavity may lead to the onset and subsequent progression of endometriosis.
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Affiliation(s)
- Takashi Ushiwaka
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan.,Department of Obstetrics and Gynecology, Kagoshima University, Kagoshima, Japan
| | - Shinpei Yamamoto
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan
| | - Chika Yoshii
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan
| | - Shoko Hashimoto
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan
| | - Tamami Tsuzuki
- Department of Obstetrics and Gynecology, Aki General Hospital, Japan
| | - Kayo Taniguchi
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan
| | - Chiaki Izumiya
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan
| | - Hiroaki Kobayashi
- Department of Obstetrics and Gynecology, Kagoshima University, Kagoshima, Japan
| | - Nagamasa Maeda
- Department of Obstetrics and Gynecology, Kochi Medical School, Kochi, Japan
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Functional changes of immune cells: signal of immune tolerance of the ectopic lesions in endometriosis? Reprod Biomed Online 2021; 43:319-328. [PMID: 34103260 DOI: 10.1016/j.rbmo.2021.04.012] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2021] [Revised: 04/06/2021] [Accepted: 04/11/2021] [Indexed: 12/28/2022]
Abstract
RESEARCH QUESTION What is the potential role of immune cells and their inflammatory cytokines in the pathogenesis, development and establishment of endometriosis? DESIGN Peritoneal fluid from 59 women (43 with endometriosis and 16 controls) who had undergone laparoscopic surgery was analysed. Changes in the population of innate and adaptive immune cells, cytokines, chemokines and growth factor expression were measured by flow cytometry, Luminex Technology and enzyme-linked immunosorbent assay. RESULTS No differences were found in the frequencies of the innate and adaptive immune cells between women with and without endometriosis. In the peritoneal fluid of women with endometriosis, IL-1β, IL-1RN, IL-2, IL-4, IL-8, IL-10, IL-12 (p70), IL-17α, FGF2, G-CSF, MCP-1, MIP-1α and TNF-α were significantly increased compared with controls. A correlation between IL-2, MCP-1, MIP-1α, TNF-α and the severity of endometriosis was observed. The concentration of neopterin, a possible biomarker for this disease, was increased in women with endometriosis compared with controls. CONCLUSIONS The functional activity of immune cells seemed to be reduced despite their numbers remaining unchanged. The data indicate that a shift of TH cytokine profile occurs, which increases the TH1-TH2 ratio. This is driven by the increased levels of the cytokines (TNF-α and IL-2) in women with severe endometriosis.
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Baka S, Frangou-Plemenou M, Panagiotopoulou E, Makrakis E, Kaltsakas G, Hassiakos D, Kondi-Pafiti A. The expression of human leukocyte antigens class I and II in women with endometriosis or adenomyosis. Gynecol Endocrinol 2011; 27:419-24. [PMID: 20569098 DOI: 10.3109/09513590.2010.495429] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES The human leukocyte antigen (HLA) system has been implicated in the aetiology of endometriosis. We aimed to compare the HLA class I and II expression in endometrial specimens from women with endometriosis or adenomyosis. METHODS We studied the HLA class I and II expression in endometrial specimens from 16 women with endometriosis and 15 with adenomyosis which were compared with 15 specimens from women without endometriosis or adenomyosis. Immunohistochemistry was performed using mouse antihuman IgG2a monoclonal antibody for HLA I and IgG1 for HLA II. RESULTS Women with endometriosis had significantly higher HLA I and II expression in stroma (100% and 87.5% vs. 66.7% and 40%, p < 0.02 and p = 0.007, respectively) and glands (87.5% and 56.3% vs. 46.7% and 20%, p < 0.02 and p = 0.04, respectively) compared to controls, while in the adenomyosis group the expression of HLA I was comparable with controls and the HLA II expression was increased in stromal cells (73.3% vs. 40%, p = 0.03) and decreased in glands (6.6% vs. 20%, p = NS). CONCLUSION Women with endometriosis had a significantly higher expression of HLA molecules whereas in adenomyosis there was a tendency of lower expression of these molecules. This could explain the suppression of cellular immunity in the peritoneal cavity.
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Affiliation(s)
- Stavroula Baka
- Department of Biopathology, Aretaieion Hospital, University of Athens, Athens, Greece.
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Gmyrek GB, Sieradzka U, Goluda M, Gabryś M, Sozański R, Jerzak M, Zbyryt I, Chrobak A, Chełmońska-Soyta A. Flow Cytometric Evaluation of Intracellular Cytokine Synthesis in Peripheral Mononuclear Cells of Women with Endometriosis. Immunol Invest 2009; 37:43-61. [DOI: 10.1080/08820130701554962] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Meola J, Rosa e Silva JC, Dentillo DB, da Silva WA, Veiga-Castelli LC, Bernardes LADS, Ferriani RA, de Paz CCP, Giuliatti S, Martelli L. Differentially expressed genes in eutopic and ectopic endometrium of women with endometriosis. Fertil Steril 2009; 93:1750-73. [PMID: 19200988 DOI: 10.1016/j.fertnstert.2008.12.058] [Citation(s) in RCA: 75] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2008] [Revised: 12/10/2008] [Accepted: 12/12/2008] [Indexed: 10/21/2022]
Abstract
OBJECTIVE To elucidate the potential mechanisms involved in the physiopathology of endometriosis. We analyzed the differential gene expression profiles of eutopic and ectopic tissues from women with endometriosis. DESIGN Prospective laboratory study. SETTING University hospital. PATIENT(S) Seventeen patients in whom endometriosis was diagnosed and 11 healthy fertile women. INTERVENTION(S) Endometrial biopsy specimens from the endometrium of healthy women without endometriosis and from the eutopic and ectopic endometrium tissues of patients with endometriosis were obtained in the early proliferative phase of the menstrual cycle. MAIN OUTCOME MEASURE(S) Six paired samples of eutopic and ectopic tissue were analyzed by subtractive hybridization. To evaluate the expression of genes found by rapid subtraction hybridization methods, we measured CTGF, SPARC, MYC, MMP, and IGFBP1 genes by real-time polymerase chain reaction in all samples. RESULT(S) This study identified 291 deregulated genes in the endometriotic lesions. Significant expression differences were obtained for SPARC, MYC, and IGFBP1 in the peritoneal lesions and for MMP3 in the ovarian endometriomas. Additionally, significant differences were obtained for SPARC and IGFBP1 between the peritoneal and ovarian lesions. No significant differences were found for the studied genes between the control and the eutopic endometrium. CONCLUSION(S) This study identified 291 genes with differential expression in endometriotic lesions. The deregulation of the SPARC, MYC, MMP3, and IGFBPI genes may be responsible for the loss of cellular homeostasis in endometriotic lesions.
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Affiliation(s)
- Juliana Meola
- Department of Genetics, School of Medicine of Ribeirão Preto, University of São Paulo, Ribeirão Preto, São Paulo, Brazil.
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Yamamoto Y, Maeda N, Izumiya C, Kusume T, Oguri H, Kawashima M, Hayashi K, Nomura A, Yamashita C, Fukaya T. Decreased human leukocyte antigen–DR expression in the lipid raft by peritoneal macrophages from women with endometriosis. Fertil Steril 2008; 89:52-9. [PMID: 17531990 DOI: 10.1016/j.fertnstert.2007.02.027] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2006] [Revised: 02/13/2007] [Accepted: 02/13/2007] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To investigate the macrophage response in endometriosis by determining the expression and localization of human leukocyte antigen (HLA)-ABC and HLA-DR by the peritoneal fluid (PF) macrophages and PF concentrations of interferon (IFN)-gamma that regulate HLA expression. DESIGN Case-control study. SETTING University hospital. PATIENT(S) 64 Japanese endometriosis patients, and 65 women with other laparoscopic diagnoses. INTERVENTION(S) Venipuncture and laparoscopic peritoneal fluid collection. MAIN OUTCOME MEASURE(S) Expression and localization of HLA-ABC and HLA-DR in PF macrophages were determined by flow cytometry and confocal microscopy. The concentration of IFN-gamma in PF was determined by enzyme-linked immunosorbent assay. RESULT(S) In women with endometriosis, expression of HLA-ABC and HLA-DR by PF macrophages, and the IFN-gamma concentrations in PF were statistically significantly lower than in controls. Women with endometriosis showed a statistically significant positive correlation between HLA expression and IFN-gamma concentration. By confocal microscopy, HLA-ABC was distributed homogenously on the macrophage surface whereas HLA-DR expression on these cells corresponded to the lipid raft. CONCLUSION(S) In women with endometriosis, low HLA expression and particularly reduced HLA-DR in the lipid raft may be influenced by low IFN-gamma and may compromise antigen presentation, limiting the immune response to peritoneal cavity antigens such as implanted or metaplastic endometrial tissue.
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Affiliation(s)
- Yorito Yamamoto
- Department of Obstetrics and Gynecology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, Japan.
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Tariverdian N, Theoharides TC, Siedentopf F, Gutiérrez G, Jeschke U, Rabinovich GA, Blois SM, Arck PC. Neuroendocrine-immune disequilibrium and endometriosis: an interdisciplinary approach. Semin Immunopathol 2007; 29:193-210. [PMID: 17621704 PMCID: PMC2668599 DOI: 10.1007/s00281-007-0077-0] [Citation(s) in RCA: 75] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2007] [Accepted: 04/15/2007] [Indexed: 01/25/2023]
Abstract
Endometriosis, a chronic disease characterized by endometrial tissue located outside the uterine cavity, affects one fourth of young women and is associated with chronic pelvic pain and infertility. However, an in-depth understanding of the pathophysiology and effective treatment strategies of endometriosis is still largely elusive. Inadequate immune and neuroendocrine responses are significantly involved in the pathophysiology of endometriosis, and key findings are summarized in the present review. We discuss here the role of different immune mechanisms particularly adhesion molecules, proteinglycan interactions, and pro-angiogenic mediators in the development and progression of the disease. Finally, we introduce the concept of endometrial dissemination as result of a neuroendocrine-immune disequilibrium in response to high levels of perceived stress caused by cardinal clinical symptoms of endometriosis.
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Affiliation(s)
- Nadja Tariverdian
- Center of Internal Medicine and Dermatology, Division of PsychoNeuroImmunology, Charité, University Medicine Berlin, Berlin, Germany
| | - Theoharis C. Theoharides
- Department of Pharmacology and Experimental Therapeutics, Tufts University School of Medicine, Boston, MA USA
| | | | - Gabriela Gutiérrez
- Institute of Humoral Immunity Studies-IDEHU (CONICET-UBA), School of Pharmacy and Biochemistry, University of Buenos Aires, Buenos Aires, Argentina
| | - Udo Jeschke
- Department of Obstetrics and Gynaecology, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Gabriel A. Rabinovich
- Institute of Biology and Experimental Medicine, IBYME-CONICET, Buenos Aires, Argentina
- Faculty of Exact and Natural Sciences, University of Buenos Aires, Buenos Aires, Argentina
| | - Sandra M. Blois
- Center of Internal Medicine and Dermatology, Division of PsychoNeuroImmunology, Charité, University Medicine Berlin, Berlin, Germany
| | - Petra C. Arck
- Center of Internal Medicine and Dermatology, Division of PsychoNeuroImmunology, Charité, University Medicine Berlin, Berlin, Germany
- Biomedizinisches Forschungszentrum, Charité, Campus Virchow, Raum 2.0549, Campus Virchow, Augustenburger Platz 1, 13353 Berlin, Germany
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Molecular profiling of experimental endometriosis identified gene expression patterns in common with human disease. Fertil Steril 2007; 87:1180-99. [PMID: 17478174 DOI: 10.1016/j.fertnstert.2006.07.1550] [Citation(s) in RCA: 73] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2006] [Revised: 07/23/2006] [Accepted: 07/23/2006] [Indexed: 12/15/2022]
Abstract
OBJECTIVE To validate a rat model of endometriosis using complimentary DNA (cDNA) microarrays by identifying common gene expression patterns between experimental and natural disease. DESIGN Autotransplantation rat model. SETTING Medical school department. ANIMALS Female Sprague-Dawley rats. INTERVENTION(S) Endometriosis was surgically induced by suturing uterine horn implants next to the small intestine's mesentery. Control rats received sutures with no implants. After 60 days, endometriotic implants and uterine horn were obtained. MAIN OUTCOME MEASURE(S) Gene expression levels determined by cDNA microarrays and real-time quantitative polymerase chain reaction (qPCR). The Cy5-labeled cDNA was synthesized from total RNA obtained from endometriotic implants. The Cy3-labeled cDNA was synthesized using uterine RNA from a control rat. Gene expression levels were analyzed after hybridizing experimental and control labeled cDNA to PIQOR (Parallel Identification and Quantification of RNAs) Toxicology Rat Microarrays (Miltenyi Biotec, Cologne, Germany) containing 1,252 known genes. The Cy5/Cy3 ratios were determined, and genes with >2-fold higher or <0.5-fold lower expression levels were selected. Microarray results were validated by QRT-PCR. RESULT(S) We observed differential expression of genes previously shown to be up-regulated in patients, including growth factors, inflammatory cytokines/receptors, tumor invasion/metastasis factors, adhesion molecules, and antiapoptotic factors. CONCLUSION(S) This study presents evidence in support of using this rat model to study the natural history of endometriosis and to test novel therapeutics for this incurable disease.
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Gmyrek GB, Sieradzka U, Goluda M, Gabryś M, Sozański R, Jerzak M, Zbyryt I, Chrobak A, Chełmońska-Soyta A. Differential flow cytometric detection of intracellular cytokines in peripheral and peritoneal mononuclear cells of women with endometriosis. Eur J Obstet Gynecol Reprod Biol 2007; 137:67-76. [PMID: 17207568 DOI: 10.1016/j.ejogrb.2006.11.017] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2006] [Revised: 11/25/2006] [Accepted: 11/29/2006] [Indexed: 10/23/2022]
Abstract
OBJECTIVE The pathogenesis of endometriosis is related to functional changes in CD3+ and CD14+ cells observed both at the local and systemic level. Here we investigated whether, and if so, how the body compartment influences cytokine expression in stimulated peritoneal and peripheral CD3+ and CD14+ cells of women with endometriosis. STUDY DESIGN Isolated peripheral blood (PB) and peritoneal fluid (PF) mononuclear cells from women with endometriosis were cultured under non-adherent conditions and stimulated with PMA and ionomycin for 6h to induce intracellular cytokine synthesis of TNF-alpha, IFN-gamma, and IL-8 by CD3+ cells or with LPS for 9h to produce TNF-alpha, IL-6, IL-10, MCP-1, and IL-8 by CD14+ cells. RESULTS The percentages of positive CD3+ cells stained for TNF-alpha and IFN-gamma were significantly higher and those stained for IL-8 were significantly lower in PF compared with PB, this being independent of the stage of endometriosis. In contrast, the percentages of CD14+ cells producing TNF-alpha, IL-6, IL-10, MCP-1, and IL-8 were significantly higher in PB than PF of women with endometriosis. CONCLUSIONS Monocytes/macrophages and lymphocytes derived from the peripheral and peritoneal compartments of women with endometriosis differentially respond to stimulated cytokine synthesis induction. However, it is difficult to state whether the observed phenomenon is more related to body compartment influence per se or to the presence of endometriosis.
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Affiliation(s)
- Grzegorz B Gmyrek
- Laboratory of Reproductive Immunology, Institute of Immunology and Experimental Therapy, Rudolfa Weigla 12, 53-114 Wroclaw, Poland.
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Bibliography. Current world literature. Minimally invasive gynecologic procedures. Curr Opin Obstet Gynecol 2006; 18:464-7. [PMID: 16794430 DOI: 10.1097/01.gco.0000233944.74672.e0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Zhang C, Maeda N, Izumiya C, Yamamoto Y, Kusume T, Oguri H, Yamashita C, Nishimori Y, Hayashi K, Luo J, Fukaya T. Killer immunoglobulin-like receptor and human leukocyte antigen expression as immunodiagnostic parameters for pelvic endometriosis. ACTA ACUST UNITED AC 2006; 55:106-14. [PMID: 16433829 DOI: 10.1111/j.1600-0897.2005.00332.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PROBLEM We investigated host immunologic responses to endometriosis by comparing immune cell surface antigens in peripheral blood (PB) and peritoneal fluid (PF) from women with endometriosis with those in PB and PF from other patients. METHOD OF STUDY Japanese women with endometriosis (n = 56) were compared with controls with other laparoscopic diagnoses (n = 68). PB and PF were collected at the time of laparoscopy for flow cytometry. RESULTS No significant difference in phenotypic parameters of T cells (CD3, CD4, and CD8), B cells (CD19), natural killer (NK) cells (CD56), or monocytes/macrophages (CD14) was seen between women with and without endometriosis. However, increased killer immunoglobulin-like receptor (CD158a) expression by NK cells and decreased human leukocyte antigen (HLA)-ABC and -DR expression by macrophages, all suggesting decreased functional activation were found in endometriosis. These markers showed significant association with endometriosis by odds ratio, logistic regression, and decision tree analyses. CONCLUSIONS Increased CD158a(+) NK cells in PB and PF indicated decreased NK cell cytotoxicity in endometriosis, while decreased HLA expression on PF macrophages suggested impaired antigen presentation. Thus, aberrant immune responses by NK cells and macrophages may represent risk factors for endometriosis.
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Affiliation(s)
- Chunbin Zhang
- Department of Biology, Jiamusi University, HeiLong Jiang, China
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