Department of Gynecological and Obstetrical Sciences and Urological Sciences, Sapienza University of Rome, Rome, Italy.
Gynecol Endocrinol. 2020 Apr;36(4):356-359. doi: 10.1080/09513590.2019.1655727. Epub 2019 Sep 3.
The immune system seems to be involved in the pathogenesis of endometriosis. Peritoneal chronic inflammation is present and natural killer cells and macrophages abnormalities have been reported in women with the disease. Moreover, a higher production of serum autoantibodies has been found, which could be related to various factors; some still need to be clarified. The correlation between endometriosis and autoimmune diseases is still unclear with few and conflicting available data. The aim of this study was to evaluate the prevalence of autoimmune diseases, as conditions with a possible common pathogenetic factor, in women affected by endometriosis, in order to address future research on its pathogenesis. This retrospective case-control study includes one hundred and forty-eight women with endometriosis and 150 controls. All women were aged between 18 and 45. Informed consent was obtained from all participants of the study. Considered autoimmune diseases include systemic lupus erythematosus (SLE), celiac disease (CD), inflammatory bowel disease (IBD), and autoimmune thyroiditis. Statistical comparison of patients and control group was performed by means of chi-square test or Fisher's exact test as appropriate. Statistical comparison of parametric variable (age) among the groups was performed by -test for unpaired data. Age was expressed as mean. A value of .05 or less was considered as significant. In the case group, five patients were affected by IBD, while the disease was not observed in the control group ( = .07). SLE was found in eight patients in the case group, while only one was found in the control group ( = .01). Fifteen women in the case group were affected by CD, while the disease was present only in one woman in the control group (<.0001). A significant correlation was also found between endometriosis and autoimmune thyroiditis: 80 patients with endometriosis had thyroid diseases versus 14 patients in the control group (<.0001). Our study reports an association between endometriosis and autoimmune disorders, showing a higher prevalence of autoimmune diseases in women affected by endometriosis. These results support a possible autoimmune pathogenesis of endometriosis.
免疫系统似乎参与了子宫内膜异位症的发病机制。患有这种疾病的女性存在腹膜慢性炎症，并且已经报道了自然杀伤细胞和巨噬细胞异常。此外，还发现了更高的血清自身抗体产生，这可能与各种因素有关；有些仍需澄清。子宫内膜异位症与自身免疫性疾病之间的相关性尚不清楚，可用数据很少且相互矛盾。本研究旨在评估患有子宫内膜异位症的女性自身免疫性疾病的患病率，这些疾病可能具有共同的发病机制因素，以便进一步研究其发病机制。这项回顾性病例对照研究包括 148 名患有子宫内膜异位症的女性和 150 名对照者。所有女性的年龄均在 18 至 45 岁之间。所有研究参与者均获得了知情同意。所考虑的自身免疫性疾病包括系统性红斑狼疮 (SLE)、乳糜泻 (CD)、炎症性肠病 (IBD) 和自身免疫性甲状腺炎。通过卡方检验或Fisher 确切检验对患者和对照组进行统计学比较。采用配对 t 检验对组间年龄等参数变量进行统计学比较。年龄用平均值表示。当.05 或更小被认为具有统计学意义。在病例组中，有 5 例患者患有 IBD，而对照组中未观察到该疾病(=.07)。在病例组中发现 8 例患者患有 SLE，而对照组中仅发现 1 例(=.01)。在病例组中，有 15 名女性患有 CD，而对照组中仅 1 名女性患有该疾病(<.0001)。子宫内膜异位症与自身免疫性甲状腺炎之间也存在显著相关性：80 名患有子宫内膜异位症的患者患有甲状腺疾病，而对照组中有 14 名患者患有甲状腺疾病(<.0001)。我们的研究报告了子宫内膜异位症与自身免疫性疾病之间的关联，表明患有子宫内膜异位症的女性自身免疫性疾病的患病率更高。这些结果支持子宫内膜异位症可能存在自身免疫发病机制。
