Lymphocytes in Endometriosis

Abstract

Endometriosis is a disease characterized by the presence of endometriotic tissue outside the uterine cavity. Although its pathogenesis remains to be elucidated, immune status is suggested to play an important role in the initiation and the progression of the disease. In particular, immune cells in lymphoid lineage that comprised T and B lymphocytes and natural killer cells play essential roles in determining either accept or reject survival, implantation, and proliferation of endometrial and endometriotic cells. Numerous studies have shown aberrant functions of these immune cells in women with endometriosis. The abnormalities include reduced activity of cytotoxic T cells and NK cells, cytokine secretion by helper T cells, and autoantibody production by B lymphocytes. These alterations are suggested to be induced by various manners and promote the disease. Understanding of these immune aspects in endometriosis is thus expected to benefit the treatment of the disease.

Mast cells in endometriosis: guilty or innocent bystanders?

“…This unique mediator profile enables MCs to initiate an inflammatory cascade leading to the observed symptoms of EMS, for example, by modulating the recruitment, survival, development, phenotype or function of other immune cells described to be involved in EMS pathology, including monocytes/macrophages, granulocytes, dendritic cells (DCs), T and B cells [5,[10][11][12][13][14].…”

Vitamin D and Female Reproduction

“…A series of immunologic changes have been reported leading to endometriosis development, including a reduction in T -cell cytotoxicity, a functional deficit of natural-killer lymphocytes and higher concentration of activated macrophages in the peritoneal fluid, which consequently trigger a cascade of cytokines and vascular endothelial growth factors promoting proliferation of endometrial cells and angiogenesis [42,43]. Genetic predisposition may play a role in incidence of endometriosis.…”

Virus Infection and Type I Interferon in Endometriosis

“…This would facilitate self-antigen presentation to autoreactive T cells and the subsequent production of autoantibodies (Kyama et al, 2003), pointing towards a pathogenic contribution by an autoimmune disease mechanism. Indeed, the frequency of autoantibodies towards endometrial antigens is elevated in both serum and peritoneal fluid of women with endometriosis compared with healthy women (Osuga et al, 2011). Activation of Th2 immune response in endometriosis and elevated B cell levels has been reported both systemically and locally in the endometriosis lesions, supposedly causing sustained autoantibody production and continuous infiltration of immune cells, thus maintaining the immunological contribution to the pathogenesis of endometriosis.…”

“…Endometrial cell clearance is presumably also reduced by altered phagocytotic properties of peritoneal macrophages. Moreover, decreased cytotoxicity towards autologous endometrial cells by decreased natural killer (NK) cell activity is thought to be an immune defect in endometriosis and is correlated with disease severity (Osuga et al, 2011). The tightly regulated balance between T helper cells type 1 (Th1) and 2 (Th2) is altered towards higher Th2 activity in women with endometriosis.…”