Department of Obstetrics and Gynecology, Hospital da Luz Lisboa, Luz Saúde, 1500-650 Lisboa, Portugal.
UCD School of Medicine, University College Dublin, D04 V1W8 Dublin, Ireland.
Int J Mol Sci. 2024 Sep 21;25(18):10141. doi: 10.3390/ijms251810141.
Endometriosis, a debilitating condition, affects one in ten women of reproductive age. Its pathophysiology remains unclear, though deficiencies in immune surveillance are thought to create an environment conducive to the evasion of ectopic endometrial cells from the immune system. Our research explores the immunological impact of endometriosis both locally and systemically, emphasizing natural killer (NK) and T cell subpopulations. We incorporated 62 female patients who underwent laparoscopic surgery; of those, 47 had endometriosis, and 15 were controls. We collected peritoneal fluid (PF) and peripheral blood (PB) samples which were tagged with monoclonal antibodies and subsequently scrutinized using flow cytometry. Our findings revealed significant differences in immunological profiles based on demographic factors and symptomatology. In the endometriosis cohort, there was an increase in PB CD56CD16 and PF CD8 CD56CD16 NK cells. CD16 CD4 T cell levels were significantly lower in the PB of endometriosis patients who smoke. Individuals with more severe disease displayed significantly higher levels of PB CD16 CD8 T cells, which also increased in those with non-menstrual pelvic pain. Dysmenorrhea severity correlated with a progressive increase in PF CD8 CD56CD16 NK cells. These variations in specific lymphocyte subsets, namely, within NK and T cells, suggest potential immunological mechanisms in the evolution and clinical presentation of endometriosis.
子宫内膜异位症是一种使人衰弱的疾病,影响着十分之一的育龄妇女。尽管人们认为免疫监视的缺陷会创造一个有利于异位子宫内膜细胞逃避免疫系统的环境,但这种疾病的病理生理学仍然不清楚。我们的研究探索了子宫内膜异位症在局部和全身的免疫学影响,重点关注自然杀伤 (NK) 和 T 细胞亚群。我们纳入了 62 名接受腹腔镜手术的女性患者;其中 47 名患有子宫内膜异位症,15 名是对照组。我们收集了腹膜液 (PF) 和外周血 (PB) 样本,并用单克隆抗体标记,然后使用流式细胞术进行仔细检查。我们的研究结果表明,基于人口统计学因素和症状,免疫图谱存在显著差异。在子宫内膜异位症组中,PB 中的 CD56CD16 和 PF 中的 CD8 CD56CD16 NK 细胞增加。吸烟的子宫内膜异位症患者 PB 中的 CD16 CD4 T 细胞水平显著降低。疾病更严重的患者 PB 中的 CD16 CD8 T 细胞显著升高,非经期盆腔疼痛患者的这些细胞也会升高。痛经严重程度与 PF CD8 CD56CD16 NK 细胞的逐渐增加相关。这些特定淋巴细胞亚群(即 NK 和 T 细胞内)的变化表明,子宫内膜异位症的发生和临床表现可能存在潜在的免疫学机制。