Yamamoto Yorito, Maeda Nagamasa, Izumiya Chiaki, Kusume Tomoaki, Oguri Hiroyoshi, Kawashima Masaaki, Hayashi Kazutoshi, Nomura Aki, Yamashita Chika, Fukaya Takao
Department of Obstetrics and Gynecology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, Japan.
Fertil Steril. 2008 Jan;89(1):52-9. doi: 10.1016/j.fertnstert.2007.02.027. Epub 2007 May 25.
To investigate the macrophage response in endometriosis by determining the expression and localization of human leukocyte antigen (HLA)-ABC and HLA-DR by the peritoneal fluid (PF) macrophages and PF concentrations of interferon (IFN)-gamma that regulate HLA expression.
Case-control study.
University hospital.
PATIENT(S): 64 Japanese endometriosis patients, and 65 women with other laparoscopic diagnoses.
INTERVENTION(S): Venipuncture and laparoscopic peritoneal fluid collection.
MAIN OUTCOME MEASURE(S): Expression and localization of HLA-ABC and HLA-DR in PF macrophages were determined by flow cytometry and confocal microscopy. The concentration of IFN-gamma in PF was determined by enzyme-linked immunosorbent assay.
RESULT(S): In women with endometriosis, expression of HLA-ABC and HLA-DR by PF macrophages, and the IFN-gamma concentrations in PF were statistically significantly lower than in controls. Women with endometriosis showed a statistically significant positive correlation between HLA expression and IFN-gamma concentration. By confocal microscopy, HLA-ABC was distributed homogenously on the macrophage surface whereas HLA-DR expression on these cells corresponded to the lipid raft.
CONCLUSION(S): In women with endometriosis, low HLA expression and particularly reduced HLA-DR in the lipid raft may be influenced by low IFN-gamma and may compromise antigen presentation, limiting the immune response to peritoneal cavity antigens such as implanted or metaplastic endometrial tissue.
通过测定腹膜液（PF）巨噬细胞中人白细胞抗原（HLA）-ABC和HLA-DR的表达及定位，以及调节HLA表达的干扰素（IFN）-γ的PF浓度，来研究子宫内膜异位症中的巨噬细胞反应。
病例对照研究。
大学医院。
64例日本子宫内膜异位症患者，以及65例经腹腔镜诊断为其他疾病的女性。
静脉穿刺和腹腔镜下收集腹膜液。
通过流式细胞术和共聚焦显微镜测定PF巨噬细胞中HLA-ABC和HLA-DR的表达及定位。通过酶联免疫吸附测定法测定PF中IFN-γ的浓度。
子宫内膜异位症患者中，PF巨噬细胞的HLA-ABC和HLA-DR表达以及PF中的IFN-γ浓度在统计学上显著低于对照组。子宫内膜异位症患者中，HLA表达与IFN-γ浓度之间存在统计学上显著的正相关。通过共聚焦显微镜观察，HLA-ABC均匀分布于巨噬细胞表面，而这些细胞上的HLA-DR表达与脂筏相对应。
在子宫内膜异位症患者中，低HLA表达，尤其是脂筏中HLA-DR的减少，可能受低IFN-γ影响，并可能损害抗原呈递，限制对腹腔抗原（如植入或化生的子宫内膜组织）的免疫反应。
