{"paper_id":"77697c58-d5e6-4243-8c75-725448b2f13c","body_text":"Abstract\nImpaired natural killer (NK) cell activity in women with endometriosis is thought to promote implantation and the progressive growth of endometrial tissue in accordance with Sampson’s hypothesis. However, the mechanisms responsible for decreased NK cell activity and the antigens recognized by NK cells in these women are not clear.\nDecreased NK cell activity in the peripheral blood (PB) and peritoneal fluid (PF) of women with endometriosis was first reported by Oosterlynck et al. and subsequent investigators have identified the depression of NK cell function in women with this disorder. Decreased NK cell activity in women with endometriosis is thought to allow the implantation of endometrial tissue in the manner of a graft, but the mechanisms underlying the decline of NK cell activity remain uncertain.\nWe focused on the expression of HLA-G, a ligand of NK cell receptors, and its changes in eutopic endometrium during the menstrual cycle. HLA-G expression was only identified in eutopic endometrium during the menstrual phase, but not during the proliferative or secretory phases. HLA-G-expressing cells were also detected in peritoneal fluid during the menstrual phase.\nRetrograde menstruation may allow HLA-G-expressing endometrial tissue to enter the peritoneal cavity, where it should be scavenged by the immune surveillance system. Because peritoneal NK cells play an important role in this system, impairment of their cytotoxicity via HLA-G could allow the survival and implantation of peritoneal endometrial cells.\nIn this article, we discuss the pathogenesis of endometriosis from the perspective of intraperitoneal interactions between NK cell receptors and their ligands (antigens) that enter the peritoneal cavity on cells shed from eutopic endometrium via retrograde menstruation.\nAccess this chapter\nTax calculation will be finalised at checkout\nPurchases are for personal use only\nSimilar content being viewed by others\nReferences\nKlein E, Masucci MG, Masucci G, Vanky F. Natural killer activity of human blood lymphocytes. Mol Immunol. 1982;19:1323–9.\nHolmberg LA, Ault KA. 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Springer, Tokyo. https://doi.org/10.1007/978-4-431-54421-0_5\nDownload citation\nDOI: https://doi.org/10.1007/978-4-431-54421-0_5\nPublished:\nPublisher Name: Springer, Tokyo\nPrint ISBN: 978-4-431-54420-3\nOnline ISBN: 978-4-431-54421-0\neBook Packages: MedicineMedicine (R0)","source_license":"CC0","license_restricted":false}