Killer Inhibitory Receptor CD158a Overexpression Among Natural Killer Cells in Women With Endometriosis is Undiminished by Laparoscopic Surgery and Gonadotropin Releasing Hormone Agonist Treatment*

Abstract

Increased percentage of CD158a(+)NK cells in peripheral blood from women with endometriosis was undiminished by laparoscopic surgery and GnRHa treatment; the persistence of CD158a(+)NK cell excess is probably related to NK cell suppression in endometriosis. This overexpression may represent a risk factor for development of endometriosis and its recurrence after treatments.

Role of NK Cells in Endometriosis

“…This suggests that KIRs expressed on NK cells can respond to their HLA class I ligands on eutopic endometrium [39][40][41]. It was also reported that progesterone induces HLA class I mRNA expression by cultured cells from secretory endometrium [51].…”

“…In women with endometriosis, expression of inhibitory killer immunoglobulin-like receptors on NK cells from PB and PF is significantly upregulated compared with the level of expression in women without endometriosis [39][40][41], indicating a decrease of NK cell activity and cytotoxicity for endometriotic cells.…”

“…Our investigations have suggested that HLA-C-expressing endometrial cells may enter the peritoneal cavity via retrograde menstruation and react with peritoneal NK cells expressing KIR2DL1 [39][40][41]. Impaired KIR2DL1 expression by peritoneal NK cells could allow endometrial cells to survive in the peritoneal cavity and undergo ectopic implantation, favoring the onset and progression of endometriosis.…”

“…The elevated percentage of KIR2DL1 + NK cells in PB from women with endometriosis was not reduced by laparoscopic surgery or by gonadotropin-releasing hormone agonist treatment. Thus, KIR2DL1 overexpression may be a primary event that represents a risk factor for both the development of endometriosis and its recurrence after treatment [40].…”

Analysis of Metallothionein, RCAS1 Immunoreactivity Regarding Immune Cell Concentration in the Endometrium and Tubal Mucosa in Ectopic Pregnancy during the Course of Tubal Rupture

“…HOXA-10 expression has been also found to be markedly decreased in endometriosis in comparison to normal endometrium [45] . Granzyme and perforin play an important role in NK-mediated cytolysis, where the process is disturbed in endometriosis [46] , while during labor NK cell activity growth is observed in endometrium [47] . The HOXA-10 overexpression observed during tubal rupture by Salih and Taylor might be related to the growing immune cytotoxic activity in the course of tubal rupture described in the present study.…”