[Activated macrophages in the peritoneal fluid of women with endometriosis: examination of the intracytoplasmic localization of endogenous peroxidase and interleukin-1].

In order to study the effect of peritoneal macrophages (M phi) on conception in patients with endometriosis, the total numbers of peritoneal M phi and the proportion of the exudate type, defined on the basis of ultracytochemical localization of endogenous peroxidase (PO) activity, were investigated in 21 patients with endometriosis, five with uterine leiomyoma, three with tubal obstruction and three with carcinomatous peritonitis. An immunocytochemical observation of interleukin-1 (IL-1) was also performed in three patients with endometriosis, one with tubal obstruction, and one male patient with cholelithiasis. The total numbers of peritoneal M phi in patients with endometriosis were significantly higher than in uterine leiomyoma (2.11 x 10(7) v.s. 0.68 x 10(7), p less than 0.025). The total numbers of peritoneal M phi in tubal obstruction (0.96 x 10(7)) were not statistically different from those in uterine leiomyoma. The peritoneal M phi were remarkably increased in number in patients with carcinomatous peritonitis. On ultracytochemical observation of endogenous PO activity, the proportion of exudate M phi to whole M phi was significantly larger in endometriosis than that in uterine leiomyoma (13.3% v.s. 3.5%, p less than 0.025). This type of M phi increased even in stage I endometriosis (p less than 0.005). These data suggest that the abdominal cavity in women with endometriosis is in the stimulated conditions which may lead to infertility. A positive reaction to anti-IL-1 antibody on the cell membrane of all M phi examined in each patient suggests that an immunocytochemical study of IL-1 in M phi is not suitable for evaluating the degree of activation of M phi.