Post Graduate Program in Gynecology and Obstetrics, Federal University of Paraná, Curitiba, Brazil.
Clinical Hospital, Federal University of Paraná, Curitiba, Brazil; Department of Medicine, Positivo University, Curitiba, Paraná, Brazil.
Immunol Lett. 2021 Mar;231:43-48. doi: 10.1016/j.imlet.2021.01.005. Epub 2021 Jan 15.
Endometriosis (EM) is a gynecologic disorder characterized by the presence of endometrium-like tissue outside of normal location that affects up to 10 % of all women in reproductive age. The pathogenesis of endometriosis is not completely known. The relationship between complement and EM has already been demonstrated in some studies, indicating an important role in the pathophysiology of the disease, however, researches are scarce and sometimes controversial. The objective of this review is to bring state-of-the-art knowledge on the subject and promote better understanding of the complement system role in the pathophysiology of EM. We searched in databases up to December 2020 and found 1213 articles that were screened, from which were selected 54 articles from title and abstract. We found that there is a dysfunction of the immune system on endometriosis, including the complement system. Apparently, the complement system is dysregulated in endometriosis and several proteins of the three complement pathways presented serum levels altered in women with endometriosis compared with those without the disease. The most studied protein is C3. Future investigations on the innate immune response and complement system could offer a further understanding on the inflammatory pathogenesis of EM, which will support a new therapeutic plan.
子宫内膜异位症（EM）是一种妇科疾病，其特征是子宫内膜样组织出现在正常位置以外，影响多达 10%的育龄妇女。子宫内膜异位症的发病机制尚不完全清楚。一些研究已经表明补体与 EM 之间存在关系，表明其在疾病的病理生理学中起着重要作用，但是研究仍然很少，而且有时存在争议。本综述的目的是介绍该领域的最新知识，并促进更好地理解补体系统在 EM 病理生理学中的作用。我们检索了截至 2020 年 12 月的数据库，共检索到 1213 篇文章，对这些文章进行筛选，从标题和摘要中选择了 54 篇文章。我们发现子宫内膜异位症存在免疫系统功能障碍，包括补体系统。显然，补体系统在子宫内膜异位症中失调，与没有该疾病的女性相比，三种补体途径的几种蛋白的血清水平发生了改变。研究最多的蛋白是 C3。对先天免疫反应和补体系统的进一步研究可以进一步了解 EM 的炎症发病机制，这将支持新的治疗计划。
