Department of Gynecology and Obstetrics, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China.
Emergency Center, Affiliated Renhe Hospital of China Three Gorges University, Yichang, Hubei, China.
Am J Reprod Immunol. 2024 Jul;92(1):e13901. doi: 10.1111/aji.13901.
Adenomyosis (AM) is associated with immune response and inflammation. However, the role of T cell subsets in AM development has not been thoroughly understood.
Patients with focal or diffuse AM were recruited. Serum cytokines were quantified by enzyme-linked immunosorbent assay (ELISA). Different T cell subsets in the blood and ectopic endometrium were determined by flow cytometry.
Serum interleukin-6 (IL-6) and macrophage-colony-stimulating factor (GM-CSF) were increased in patients with focal or diffuse AM before focused ultrasound ablation surgery (FUAS), but not after FUAS. Compared with the healthy control, the frequencies of CD8 interferon-gamma (IFN-γ)-expressing cytotoxic T lymphocytes (CTLs), interleukin-17A (IL-17A)-expressing Tc17 cells, CD4 T helper 1 (Th1) cells, and GM-CSF-expressing T helper (ThGM) cells were up-regulated in the blood of patients with AM, especially those with diffuse AM. However, these changes were eradicated after FUAS. Meanwhile, the frequencies of these T cell subsets were positively correlated with the CA-125 level. Furthermore, these T cell subsets were also increased in ectopic endometrium.
Our study delineates for the first time the presence of CTLs, Tc17 cells, Th1, and ThGM cells in the blood and ectopic endometrium in AM. The results imply that T cell response might impact AM development.
子宫腺肌病（AM）与免疫反应和炎症有关。然而，T 细胞亚群在 AM 发展中的作用尚未被充分理解。
招募了患有局灶性或弥漫性 AM 的患者。通过酶联免疫吸附试验（ELISA）定量血清细胞因子。通过流式细胞术测定血液和异位子宫内膜中的不同 T 细胞亚群。
在聚焦超声消融手术（FUAS）之前，局灶性或弥漫性 AM 患者的血清白细胞介素-6（IL-6）和巨噬细胞集落刺激因子（GM-CSF）增加，但 FUAS 后则不增加。与健康对照组相比，AM 患者的血液中 CD8 干扰素-γ（IFN-γ）表达的细胞毒性 T 淋巴细胞（CTL）、白细胞介素-17A（IL-17A）表达的 Tc17 细胞、CD4 T 辅助 1（Th1）细胞和 GM-CSF 表达的辅助 T（ThGM）细胞的频率升高，尤其是弥漫性 AM 患者。然而，这些变化在 FUAS 后被消除。同时，这些 T 细胞亚群的频率与 CA-125 水平呈正相关。此外，这些 T 细胞亚群在异位子宫内膜中也增加。
我们的研究首次描绘了 AM 患者血液和异位子宫内膜中 CTLs、Tc17 细胞、Th1 和 ThGM 细胞的存在。结果表明 T 细胞反应可能影响 AM 的发展。
