Endometriosis and inflammatory immune responses: Indian experience

Abstract

Endometriosis is a public health disorder affecting ∼ 247 million women globally and ∼ 42 million women in India. Women with endometriosis suffer from dysmenorrhea, chronic pelvic pain, dyspareunia, dyschezia, fatigue, depression, and infertility leading to significant socioeconomic impact and morbidity. The etiology of endometriosis is not understood well even after 100 years of research. Currently, there is no permanent cure for endometriosis. The inflammatory immune response is one of the important features of etiopathogenesis of endometriosis and therefore understanding the inflammatory immune response would lead to a better understanding of this enigmatic disorder and may also lead to biomarker discovery for diagnosis of endometriosis.We investigated the autoimmune etiology of endometriosis in the Indian population.Using the proteomics approach, anti-endometrial antibodies (AEAs) were detected in Indian women with endometriosis [anti-endometrial antibodies -tropomyosin 3 (TPM3), stomatin-like protein2 (SLP-2), and tropomodulin 3 (TMOD3)]. The studies on AEAs provided a better understanding of autoimmune mechanisms in endometriosis. All three subtypes of endometriosis; superficial peritoneal, ovarian endometrioma, and deep infiltrating endometriosis were reported in Indian women. In this review, we discuss our experiences of the inflammatory immune response, autoimmunity, comorbidities, and clinical phenotypes in women with endometriosis in India.

Regulated Cell Death in Endometriosis

“…This makes one wonder why some people are normal and others have endometriosis. Some studies have shown that the immune system's failure to clear the ectopic endometrium in time or its failure to clear it is also one of the important causes of endometriosis [22,23]. It has been found that the expression of the anti-apoptotic genes is up-regulated in the eutopic and ectopic endometrium of patients with endometriosis, which proves that there is an anti-apoptotic phenomenon in endometriosis [24].…”

Special issue: Clinical reproductive immunology: Indian perspective

“…11 Gajbhiye R. reviewed their group's experiences of the inflammatory immune response, autoimmunity, comorbidities and clinical phenotypes in Indian women with endometriosis. 12 Their investigations revealed presence of anti-endometrial antibodies (AEAs) in Indian women with endometriosis that are majorly targeting tropomyosin 3, stomatin-like protein2 and tropomodulin 3. necrosis factor along with the promising novel immunomodulatory therapies. 14 The role of immune dysregulation in male infertility is an area relatively less researched.…”

“…Pires and Parikh have reviewed the literature on the relevance and efficacy of immunoassays for anti‐ovarian antibodies including their own efforts to identify the cause and a method to overcome non‐specificity in these immunoassays 11 . Gajbhiye R. reviewed their group's experiences of the inflammatory immune response, autoimmunity, comorbidities and clinical phenotypes in Indian women with endometriosis 12 . Their investigations revealed presence of anti‐endometrial antibodies (AEAs) in Indian women with endometriosis that are majorly targeting tropomyosin 3, stomatin‐like protein2 and tropomodulin 3.…”

Potential Significance of Serum Autoantibodies to Endometrial Antigens, α-Enolase and Hormones in Non-Invasive Diagnosis and Pathogenesis of Endometriosis

“…Endometriosis is a benign estrogen-dependent chronic systemic inflammatory gynecological condition with multifactorial etiopathogenesis. The disease is characterized by the presence of actively functioning foci of endometrium (glandular cells and stroma) or endometrial tissue outside the uterine cavity, i.e., in the muscular layer of the uterine wall or in the other organs of reproductive system, or/and in the adjacent or distant structures [1][2][3]. Being a common gynecologic disease, endometriosis occurs in 10-15% of women of reproductive age, including 35-50% of women with pelvic pain and/or infertility [1].…”

“…Endometriosis often leads to chronic pelvic pain, dysmenorrhea, dyspareunia, infertility, and impaired quality of life, significantly burdening health in general [2,3], as confirmed by reliable special questionnaires [5], and represents a serious medical and socioeconomic problem. The lack of specific signs and symptoms makes accurate diagnosis a major challenge.…”