Laboratory of Immunology, Heart Institute (InCor), Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Histocompatibility and Cellular Immunology Laboratory, LIM-19, Hospital das Clínicas HCFMUSP, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
Reprod Sci. 2021 Jan;28(1):291-304. doi: 10.1007/s43032-020-00255-x. Epub 2020 Jul 14.
Endometriosis (EDT) is an inflammatory disease characterized by implantation/growth of endometrial tissue, glands, and/or stroma, outside the uterus. Reduced NK cell cytotoxic activity has been implicated in its pathogenesis, together with other immunologic alterations. We investigated the influence of KIR gene polymorphisms and their HLA ligand combinations in deep endometriosis (DE) susceptibility. One hundred sixty women with a histological diagnosis of DE and 202 control women without the disease, who underwent laparoscopy, were enrolled. The DE group was subdivided into initial (I/II; n = 60) and advanced stages (III/IV, n = 100). KIR and HLA class I gene polymorphisms were typed by PCR-SSP and sequence-based-typing (SBT), respectively. We observed a significant association of KIR2DL2, an inhibitory gene of B haplotype, conferring risk for DE in Euro-descendants. Positive associations of Bx haplotype and centromeric AB segments were also found. However, no association with KIR-HLA ligand combination was observed. Our data suggest KIR2DL2 gene to be a relevant factor favoring NK inhibition in DE in Euro-descendants, contributing to the defective NK cytotoxic activity and impaired clearance of ectopic endometrial cells in the disease.
子宫内膜异位症(EDT)是一种炎症性疾病,其特征是子宫内膜组织、腺体和/或基质在子宫外植入/生长。其发病机制与 NK 细胞细胞毒性活性降低以及其他免疫改变有关。我们研究了 KIR 基因多态性及其 HLA 配体组合对深部子宫内膜异位症(DE)易感性的影响。招募了 160 名经组织学诊断为 DE 的女性和 202 名无该病的对照女性,她们均接受了腹腔镜检查。将 DE 组分为初始(I/II;n=60)和晚期(III/IV,n=100)阶段。通过 PCR-SSP 和基于序列的分型(SBT)分别对 KIR 和 HLA I 类基因多态性进行分型。我们观察到抑制性 B 单倍型的 KIR2DL2 基因与 DE 在欧洲裔人群中的易感性显著相关。还发现 Bx 单倍型和着丝粒 AB 片段呈阳性关联。然而,没有观察到 KIR-HLA 配体组合与 DE 之间的关联。我们的数据表明,KIR2DL2 基因是促进 DE 中 NK 抑制的一个重要因素,有助于 NK 细胞毒性活性缺陷和疾病中外位子宫内膜细胞清除受损。