{"paper_id":"e17cdb34-13f2-475c-ae78-79afb5487231","body_text":"Abstract\nEndometriosis is a poorly understood disease of unknown aetiology and histogenesis. It affects women as well as menstruating female primates of other species. The disease is characterized by ectopic growth and function of endometrial cells. Current data indicate that endometriosis begins with retrograde transport through the fallopian tubes into the peritoneal cavity of endometrial cells or fragments desquamated during the menstrual period. These cells (or tissue fragments) then implant, proliferate and develop into characteristic endometriotic lesions. Under cyclic stimulation of the ovarian hormones, ectopic endometrial cells undergo similar cyclic changes to those of the uterine endometrium. From the peritoneal cavity, endometriosis may spread through lymphatic and vascular channels into distant locations. Alternatively, endometrial cells from the uterus may disseminate systemically into the pelvic cavity and distant locations. It is unclear why, in some women, endometrial cells are transported through lymphatic and vascular channels to various parts of the body, and why they are allowed to implant and function in the ectopic sites. In many respects, this process resembles metastases of neoplastic cells and is the reason why endometriosis in the past has been referred to as ‘a benign cancer’.\nPreview\nUnable to display preview. Download preview PDF.\nSimilar content being viewed by others\nReferences\nSampson, J.A. (1925). Heterotropic or misplaced endometrial tissue. Am. J. Obstet. Gynecol., 10, 649\nBartosik, D., Jacobs, S.L. and Kelly, L.J. (1986). Endometrial tissue in peritoneal fluid. Fertil. Steril., 46, 796–800\nWood, D.H., Yochmowitz, M.G., Salmon, Y.L., Eason, R.L. and Boster, R.A. (1983). Proton irradiation and endometriosis. Aviat. Space Environ. Med., 54, 718–724\nCampbell, J.S., Wong, J., Tryphonas, L., Arnold, D.L., Nera, E., Cross, B. and LaBossiere, E. (1985). Is simian endometriosis an effect of immunotoxicity? Presented at the Annual Meeting, Ontario Association of Pathology, October 4, London, Ontario\nGleicher, N., El-Roeiy, A., Confino, E. and Friberg, J. (1987). Abnormal autoantibodies in endometriosis: Is endometriosis an autoimmune disease? Obstet. Gynecol., 70, 115–122\nDmowski, W.P., Gebel, H.M. and Rawlins, R.G. (1989). Immunologic aspects of endometriosis. Obstet. Gynecol. Clin. North Am., 16, 93–103\nEngleman, E.G., Warnke, R., Fox, R.I., Dilley, S., Benili, C.J. and Levy, R. (1981). Studies of a human T lymphocyte antigen recognized by a monoclonal antibody. Proc. Natl Acad. Sci., USA, 78, 1791–1795\nMorimoto, C., Letvin, N., Boyd, A., Hagan, M., Brown, H., Kornacki, M. and Schlossman, S.F. (1985). The isolation and characterization of the human helper inducer cell subset. J. Immuno., 134, 3762–3769\nMorimoto, G, Letvin, N., Distaso, J., Aldrich, W. and Schlossman, S.F. (1985). The isolation and characterization of the human suppressor inducer T cells subset. J. Immunol., 134, 1508–1515\nSanders, M.E., Makgoba, M.W. and Shaw, S. (1987). Human naive and memory T cells. Immunol. Today, 1, 1–3\nDamle, N.K. and Engleman, E.G. (1983). Immunoregulatory T cells circuits in man: alloantigen-primed T cells activate alloantigen-specific suppressor T cells in the absence of the initial antigen stimulus. J. Exp. Med., 158, 159–173\nLanday, A., Gartland, G.L. and Clemant, L. (1983). Characterization of a phenotypically distinct subpopulation of Leu 2+ cells which suppress T cell proliferation responses. J. Immunol., 131, 2757–2761\nStashenko, P., Nadler, L.M., Hardy, R. and Scholssman, S.F. (1980). Characterization of human B lymphocyte specific antigen. J. Immunol., 125, 1678–1685\nGadol, N. and Ault, K.A. (1986). Phenotypic and functional characterization of human Leu 1 (CD5) B cells. Immunol Rev., 93, 23–24\nLydyard, P.M., Youinou, P.Y. and Cooke, A. (1987). CD5-positive B cells in rheumatoid arthritis and chronic lymphocytic leukemia. Immunol. Today, 8, 37–38\nJohnston, R. (1988). Monocytes and macrophages. N. Engl. J. Med., 318, 747–752\nBasham, T., Smith, W., Lanier, L., Morhenn, U. and Merigan, T. (1984). Regulation of expression of class II major histocompatibility antigens on human peripheral blood monocytes and Langerhans cells by interferon. Human Immunol., 10, 83–93\nAdes, E. and Lopez, C. (eds.) (1989). Natural Killer Cells and Host Defense. (San Francisco: Karger)\nCascon, P., Zoumbos, N. and Young, N. (1986). Analysis of natural killer cells in patients with aplastic anemia. Blood, 67, 1349–1355\nBray, R.A., Gottschalk, L.R., Landay, A.L. and Gebel, H.M. (1987). Differential surface marker expression in patients with CD 16+ lymphoproliferative disorders: In vivo model for NK differentiation. Human Immunol., 19, 105–115\nMiller, J.F.A.P., Morahan, G. and Allison, J. (1989). Immunological tolerance; New approaches using transgenic mice. Immunol. Today, 10, 53–57\nKappler, J.W., Roehm, N. and Marrack, P. (1987). T cell tolerance by clonal elimination in the thymus. Cell, 49, 273–280\nSha, W.C., Nelson, C.S., Newberry, R.D., Kranz, D.M., Russell, J.H. and Loh, D.Y. (1988). Positive and negative selection of an antigen receptor on T cells in transgenic mice. Nature, 336, 73–76\nGoodnow, C.C., Crosbie, J., Adelstein, S., Lavoie, T.B., Smith-Gill, S.J., Brink, R.A., Pritchard-Briscoe, H., Wotherspoon, J.S., Loblay, R.H., Raphael, K., Trent, R.J. and Basten, A. (1988). Altered immunoglobulin expression and functional silencing of self-reactive B lymphocytes in transgenic mice. Nature, 334, 676–682\nKisielow, P., Bluthmann, H., Staerz, U.D., Steinmetz, M. and von Boehmer, H. (1988). Tolerance in T-cell-receptor transgenic mice involves deletion of nonmature CD4 + 8 + thymocytes. Nature, 333, 742–746\nArnold, B., Dill, O., Kublbeck, G., Jatsch, L., Simon, M.M., Tucker, J. and Hammerling, G.J. (1988). Alloreactive immune responses of transgenic mice expressing a foreign transplantation antigen in a soluble form. Proc. Natl Acad. Sci., USA, 85, 2269–2273\nSteele, R.W., Eichberg, J.W., Heberling, R.L., Kalter, S.S. and Kniker, W.T. (1977). Correlation of mixed lymphocyte reactivity and skin graft rejection in nonhuman primates. J. Med. Primatol., 6, 119–126\nShirai, M., Matsushita, S., Kagayama, M., Ichijo, S. and Takeuchi, M. (1966). Histological changes of the scrotal testis in unilateral cryptorchidism. Tohoku J. Exp. Med., 90, 363–373\nWeksler, M.E., Moody, C.E. and Kozak, R.W. (1981). The autologous mixed lymphocyte reaction. Adv. Immunol., 31, 271–312\nEngleman, E.G., Benike, C.J., Hoppe, R.T., Kaplan, H.S. and Berberich, F.R. (1980). Autologous mixed lymphocyte reaction in patients with Hodgkin’s disease. Evidence for a T-cell defect. J. Clin. Invest., 66, 149–158\nSakane, T., Steinberg, A.P. and Green, I. (1978). Failure of autologous mixed lymphocyte reactions between T and non-T cells in patients with systemic lupus erythematosus. Proc. Natl Acad. Sci, USA, 75, 3464\nStartseva, N.V. (1980). Clinico-immunological aspects of genital endometriosis. Akush. Ginekol. (Mosk.), 3, 23–26\nWeed, J.C. and Arguembourg, P.C. (1980). Endometriosis: can it produce an autoimmune response resulting in infertility? Clin. Obstet. Gynecol., 23, 885–893\nMathur, S., Peress, M.R., Williamson, H.O., Youmans, C.D., Maney, S.A., Garvin, A.J., Rust, P.F. and Fudenberg, H.H. (1982). Autoimmunity to endometrium and ovary in endometriosis. Clin. Exp. Immunol., 50, 259–266\nMathur, S., Chihal, H.J., Homm, R.J., Garza, D.E., Rust, P.F. and Williamson, H.O. (1988). Endometrial antigens involved in the autoimmunity of endometriosis. Fertil. Steril., 50, 860–863\nBadawy, S.Z., Cuenca, V., Stitzel, A., Jacobs, R.D. and Tomar, R.H. (1984). Autoimmune phenomena in infertile patients with endometriosis. Obstet. Gynecol., 63, 271–275\nKreiner, D., Fromowitz, F.B., Richardson, D.A. and Kenigsberg, D. (1986). Endometrial immunofluorescence associated with endometriosis and pelvic inflammatory disease. Fertil. Steril., 46, 243–245\nSaifuddin, A., Buckley, C.H. and Fox, H. (1983). Immunoglobulin content of the endometrium in women with endometriosis. Int. J. Gynecol. Pathol., 2, 255–263\nWild, R.A. and Shivers, C.A. (1985). Antiendometrial antibodies in patients with endometriosis. Am. J. Reprod. Immunol. Microbiol., 8, 84–86\nCowchock, S., Smith, J.B. and Gocial, B. (1986). Autoantibodies to phospholipids and nuclear antigens in patients with repeated abortions. Am. J. Obstet. Gynecol., 155, 1002–1010\nGleicher, N., El-Roeiy, A., Confino, E. and Friberg, J. (1987). Autoantibodies in patients with unexplained infertility and recurrent pregnancy loss (abstract 249). Presented at the 34th Annual Meeting, Society for Gynecologic Investigation, March 18–21, Atlanta, p. 153\nEl-Roeiy, A., Dmowski, W.P., Gleicher, N., Radwanska, E., Harlow, L., Binor, Z., Tummon, I. and Rawlins, R.G. (1988). Danazol but not gonadotropin-releasing hormone agonist suppresses autoantibodies in endometriosis. Fertil. Steril., 50, 864–871\nMeek, S.C., Hodge, D.D. and Musich, J.R. (1988). Autoimmunity in infertile patients with endometriosis. Am. J. Obstet. Gynecol., 158, 1365–1373\nSteele, R.W., Dmowski, W.P. and Marmer, D.J. (1984). Immunologic aspects of human endometriosis. Am. J. Reprod. Immunol., 6, 33–36\nPittaway, D.E. (1989). CA-125 in women with endometriosis. Obstet. Gynecol Clin. North Am., 16, 273–252\nDmowski, W.P., Steele, R.W. and Baker, G.F. (1981). Deficient cellular immunity in endometriosis. Am. J. Obstet. Gynecol., 141, 377–383.\nGleicher, N., Dmowski, W.P., Siegel, I., Liu, T.L., Friberg, J., Radwanska, E. and Toder, V. (1984). Lymphocyte subsets in endometriosis. Obstet. Gynecol., 63, 463–466\nBadawy, S.Z., Cuenca, V., Stitzel, A. and Tice, D. (1987). Immune rosettes of T and B lymphocytes in infertile women with endometriosis. J. Reprod. Med., 32, 194–197\nHalme, J., Becker, S. and Wing, R. (1984). Accentuated cyclic activation of peritoneal macrophages in patients with endometriosis. Am. J. Obstet. Gynecol., 148, 85–90\nHaney, A.F., Muscato, J.J. and Weinberg, J.B. (1981). Peritoneal fluid cell populations in infertility patients. Fertil. Steril., 35, 696–698\nZeller, J.M., Henig, I., Radwanska, E. and Dmowski, W.P. (1987). Enhancement of human monocyte and peritoneal macrophage chemiluminescence activities in women with endometriosis. Am. J. Reprod. Immunol. Microbiol., 13, 78–82\nFakih, H., Baggett, B., Holtz, G., Tsang, K.Y., Lee, J.C. and Williamson, H.O. (1987). Interleukin-1: a possible role in the infertility associated with endometriosis. Fertil. Steril., 47, 213–217\nKauma, S., Clark, M.R., White, C. and Halme, J. (1988). Production of fibronectin by peritoneal macrophages and concentration of fibronectin in peritoneal fluid from patients with or without endometriosis. Obstet. Gynecol., 72, 13–18\nParvizi, S.T., Jensen, P., DeCherney, A., Polan, M.L. and Comite, F. (1988). Elevated interleukin-1 (IL-1) synthesis by peripheral monocytes in endometriosis (abstract 450). Presented at the 35th Annual Meeting, Society for Gynecologic Investigation, March 17–20, Baltimore, p. 284.\nHalme, J., Becker, S. and Haskill, S. (1987). Altered maturation and function of peritoneal macrophages: possible role in pathogenesis of endometriosis. Am. J. Obstet. Gynecol., 156, 783–789\nAhn, Y.S., Harrington, W.J., Simon, S.R., Mylvaganam, R., Pall, L.M. and So, A.G. (1983). Danazol for the treatment of idiopathic thrombocytopenic purpura. N. Engl. J. Med., 308, 1396–1399\nAgnello, V., Pariser, K., Gell, J., Gelfand, J. and Turksoy, R.N. (1983). Preliminary observations on danazol therapy of systemic lupus erythematosus: effects on DNA antibodies, thrombocytopenia and complement. J. Rheumatol., 10, 682–687\nGelfand, J.A., Sherins, R.J., Alling, D.W. and Frank, M.M. (1976). Treatment of hereditary angioedema with danazol: Reversal of clinical and biochemical abnormalities. N. Engl. J. Med., 295, 1444–1448\nGralnick, H.R. and Rick, M.E. (1983). Danazol increases Factor VIII and Factor IX in classic hemophilia and Christmas disease. N. Engl. J. Med., 308, 1393–1395\nMylvaganam, R., Ahn, Y.S., Harrington, W.J. and Kim, C.I. (1987). Immune modulation by danazol in autoimmune thrombocytopenia. Clin. Immunol. Immunopathol., 42, 281–287\nHill, J.A., Barbieri, R.L. and Anderson, D.J. (1987). Immunosuppressive effects of danazol in vitro. Fertil. Steril., 48, 414–418\nGrimes, D.A., LeBolt, S.A., Grimes, K.R. and Wingo, P.A. (1985). Systemic lupus erythematosus and reproductive function: a case control study. Am. J. Obstet. Gynecol., 153, 179–186\nDmowski, W.P., Braun, D., Gebel, H., Rotman, C. and Madanes, A. Peripheral blood monocyte (PBM) and peritoneal macrophage (PM) cytotoxicity in women with endo metriosis and the effect of danazol. 46th Annual Meeting of the American Fertility Society, Washington, D.C., October, 1990\nBraun, D.P., Harris, J.E. and Rubenstein, M. (1984). Relationship of arachidonic acid metabolism to indomethacin sensitive immunoregulatory function and lymphocyte PGE sensitivity and peripheral blood mononuclear cells of disseminated solid tumor cancer patients. J. Immunol. Pharmacol., 6(3), 227–236\nEditor information\nEditors and Affiliations\nRights and permissions\nCopyright information\n© 1991 Springer Science+Business Media Dordrecht\nAbout this chapter\nCite this chapter\nDmowski, W.P., Braun, D., Gebel, H. (1991). The immune system in endometriosis. In: Thomas, E.J., Rock, J.A. (eds) Modern Approaches to Endometriosis. Springer, Dordrecht. https://doi.org/10.1007/978-94-011-3864-2_6\nDownload citation\nDOI: https://doi.org/10.1007/978-94-011-3864-2_6\nPublisher Name: Springer, Dordrecht\nPrint ISBN: 978-94-010-5719-6\nOnline ISBN: 978-94-011-3864-2\neBook Packages: Springer Book Archive\nKeywords\nThese keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.","source_license":"CC0","license_restricted":false}