Freitag Nadine, Baston-Buest Dunja M, Kruessel Jan-Steffen, Markert Udo R, Fehm Tanja N, Bielfeld Alexandra P
Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
Department of Obstetrics, Gynecology and REI (UniKiD), Medical Faculty, Medical Center University of Düsseldorf, Moorenstr. 5, 40225 Düsseldorf, Germany.
J Reprod Immunol. 2022 Mar;150:103489. doi: 10.1016/j.jri.2022.103489. Epub 2022 Jan 29.
There is growing evidence that changes in the eutopic endometrial immune profile are a cause of endometriosis-associated infertility. Women affected by endometriosis experience a 2-fold increased risk of infertility compared to healthy controls. In our study we aimed to map out endometrial expressions of uterine natural killer cells, plasma cells, macrophages and the chemokine CXC-motif ligand 1 (CXCL1) as well as its main receptors CXC-motif receptor 2 (CXCR2) and Syndecan-1 in infertility-patients with endometriosis. 36 infertility patients were included of which 19 suffered from endometriosis and 17 served as a control cohort. All patients underwent endometrial scratching in the secretory phase and immunohistochemical staining which was evaluated by three independent observers. In endometriosis-patients, a higher concentration of macrophages coincided with an elevated number of uterine natural killer cells or plasma cells. Patients with endometriosis also showed a higher endothelial expression of VEGF-A. Furthermore, absence of stromal expression of SDC-1 was associated with an elevated level of uNK in general. Therefore, our study links endometriosis to an altered immune cell population in the eutopic endometrium, which might be a new approach to diagnosing endometriosis in infertility patients.
越来越多的证据表明，在位子宫内膜免疫谱的变化是子宫内膜异位症相关性不孕的一个原因。与健康对照组相比，受子宫内膜异位症影响的女性不孕风险增加了两倍。在我们的研究中，我们旨在描绘子宫自然杀伤细胞、浆细胞、巨噬细胞以及趋化因子CXC基序配体1（CXCL1）及其主要受体CXC基序受体2（CXCR2）和Syndecan-1在子宫内膜异位症不孕患者中的子宫内膜表达情况。纳入了36例不孕患者，其中19例患有子宫内膜异位症，17例作为对照队列。所有患者在分泌期进行子宫内膜刮除术并进行免疫组织化学染色，由三名独立观察者进行评估。在子宫内膜异位症患者中，较高浓度的巨噬细胞与子宫自然杀伤细胞或浆细胞数量增加同时出现。子宫内膜异位症患者还表现出较高的血管内皮生长因子A（VEGF-A）内皮表达。此外，一般来说，Syndecan-1（SDC-1）基质表达缺失与子宫自然杀伤细胞（uNK）水平升高有关。因此，我们的研究将子宫内膜异位症与在位子宫内膜中免疫细胞群体的改变联系起来，这可能是诊断不孕患者子宫内膜异位症的一种新方法。
