Coordinated but depressed expression of human leukocyte antigen-DR, intercellular adhesion molecule-1, and CD14 on peritoneal macrophages in women with pelvic endometriosis.

OBJECTIVE

To investigate the macrophage response in endometriosis, we determined the expression of human leukocyte antigen (HLA)-DR, intercellular adhesion molecule (ICAM)-1, and CD14 on peritoneal macrophages.

DESIGN

Case-control study of immunologic markers.

SETTING

University hospital.

PATIENT(S): Forty-five Japanese women with endometriosis were compared with 48 control subjects with other laparoscopic diagnoses.

INTERVENTION(S): Venipuncture and laparoscopic peritoneal fluid (PF) collection.

MAIN OUTCOME MEASURE(S): Expression of HLA-DR, ICAM-1, and CD14 on peripheral blood (PB) monocytes and PF macrophages were quantitated as mean fluorescence intensities by flow cytometry. Expression of each marker on PF macrophages was divided by that on PB monocytes, as an index of macrophage activation (macrophage activation ratio).

RESULT(S): In women with endometriosis, PF macrophages showed significant positive correlations between expression of HLA-DR and ICAM-1, HLA-DR and CD14, and ICAM-1 and CD14. However, expression of individual markers on PF macrophages and their activation ratios were significantly lower than in control.

CONCLUSION(S): Coordinated but relatively low expression of HLA-DR, ICAM-1, and CD14 on PF macrophages indicates a positive but limited immune response to events in the peritoneal cavity in women with endometriosis, which may induce immune tolerance to implanted or metaplastic endometrial tissue.