Amphia Hospital, 4838 Breda, The Netherlands.
Center of Translational Immunology, University Medical Center, 3553 Utrecht, The Netherlands.
Int J Mol Sci. 2022 May 16;23(10):5539. doi: 10.3390/ijms23105539.
Endometriosis is a gynaecological disease defined by the growth of endometrium-like tissue outside the uterus. The disease is present in approximately 5-10% of women of reproductive age and causes pelvic pain and infertility. The pathophysiology is not completely understood, but retrograde menstruation and deficiency in natural killer (NK) cells that clear endometriotic cells in the peritoneal cavity play an important role. Nowadays, hormonal therapy and surgery to remove endometriosis lesions are used as treatment. However, these therapies do not work for all patients, and hormonal therapy prevents patients from getting pregnant. Therefore, new treatment strategies should be developed. Since the cytotoxicity of NK cells is decreased in endometriosis, we performed a literature search into the possibility of NK cell therapy. Available treatment options include the inhibition of receptor-ligand interaction for KIR2DL1, NKG2A, LILRB1/2, and PD-1/PD-L1; inhibition of TGF-β; stimulation of NK cells with IL-2; and mycobacterial treatment with BCG. In preclinical work, these therapies show promising results but unfortunately have side effects, which have not specifically been studied in endometriosis patients. Before NK cell treatment can be used in the clinic, more research is needed.
子宫内膜异位症是一种妇科疾病，其定义为子宫内膜样组织在子宫外生长。该疾病在育龄妇女中的发病率约为 5-10%，可导致盆腔疼痛和不孕。其病理生理学尚未完全阐明，但逆行性月经和清除腹腔内子宫内膜异位细胞的自然杀伤 (NK) 细胞不足在其中发挥了重要作用。目前，采用激素治疗和手术切除子宫内膜异位症病灶作为治疗方法。然而，这些疗法并非对所有患者都有效，且激素治疗会妨碍患者怀孕。因此，需要开发新的治疗策略。由于 NK 细胞的细胞毒性在子宫内膜异位症中降低，我们对 NK 细胞疗法的可能性进行了文献检索。现有的治疗选择包括抑制 KIR2DL1、NKG2A、LILRB1/2 和 PD-1/PD-L1 的受体-配体相互作用；抑制 TGF-β；用 IL-2 刺激 NK 细胞；以及用卡介苗进行分枝杆菌治疗。在临床前研究中，这些疗法显示出有前景的结果，但不幸的是，它们都具有副作用，而这些副作用在子宫内膜异位症患者中尚未得到专门研究。在 NK 细胞治疗能够应用于临床之前，还需要开展更多的研究。
