Ścieżyńska Aneta, Komorowski Michał, Soszyńska Marta, Malejczyk Jacek
Department of Histology and Embryology, Medical University of Warsaw, Chałubińskiego 5, 02-004 Warsaw, Poland.
Laboratory for Experimental Immunology, Military Institute of Hygiene and Epidemiology, 01-163 Warsaw, Poland.
J Clin Med. 2019 Sep 14;8(9):1468. doi: 10.3390/jcm8091468.
Endometriosis is a common gynecological disease defined by the presence of endometrial-like tissue outside the uterus, most frequently on the pelvic viscera and ovaries, which is associated with pelvic pains and infertility. It is an inflammatory disorder with some features of autoimmunity. It is accepted that ectopic endometriotic tissue originates from endometrial cells exfoliated during menstruation and disseminating into the peritoneum by retrograde menstrual blood flow. It is assumed that the survival of endometriotic cells in the peritoneal cavity may be partially due to their abrogated elimination by natural killer (NK) cells. The decrease of NK cell cytotoxic activity in endometriosis is associated with an increased expression of some inhibitory NK cell receptors. It may be also related to the expression of human leukocyte antigen G (HLA-G), a ligand for inhibitory leukocyte immunoglobulin-like receptor subfamily B member 1 (LILRB1) receptors. The downregulated cytotoxic activity of NK cells may be due to inhibitory cytokines present in the peritoneal milieu of patients with endometriosis. The role of NK cell receptors and their ligands in endometriosis is also confirmed by genetic association studies. Thus, endometriosis may be a subject of immunotherapy by blocking NK cell negative control checkpoints including inhibitory NK cell receptors. Immunotherapies with genetically modified NK cells also cannot be excluded.
子宫内膜异位症是一种常见的妇科疾病，其定义为子宫外存在类似子宫内膜的组织，最常见于盆腔脏器和卵巢，与盆腔疼痛和不孕有关。它是一种具有自身免疫某些特征的炎症性疾病。公认异位子宫内膜组织起源于月经期间脱落的子宫内膜细胞，并通过逆行月经血流扩散到腹膜。据推测，子宫内膜异位细胞在腹腔内的存活可能部分归因于自然杀伤（NK）细胞对其清除作用的减弱。子宫内膜异位症中NK细胞细胞毒性活性的降低与一些抑制性NK细胞受体表达的增加有关。这也可能与人类白细胞抗原G（HLA - G）的表达有关，HLA - G是抑制性白细胞免疫球蛋白样受体亚家族B成员1（LILRB1）受体的配体。NK细胞细胞毒性活性下调可能是由于子宫内膜异位症患者腹膜环境中存在的抑制性细胞因子。NK细胞受体及其配体在子宫内膜异位症中的作用也得到了基因关联研究的证实。因此，子宫内膜异位症可能是通过阻断包括抑制性NK细胞受体在内的NK细胞负性控制检查点进行免疫治疗的对象。也不能排除使用基因改造的NK细胞进行免疫治疗。
