Natural cytotoxicity and gnrh agonist administration in advanced endometriosis: positive modulation on natural killer activity
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Abstract
OBJECTIVE: To investigate the effects of pharmacologic suppression of ovarian function on the immune system, with respect to the clinical outcome of endometriosis and the possibility of an immunoendocrine combined treatment. METHODS: After informed consent, 25 of 37 patients with revised American Fertility Society stage III and IV endometriosis who underwent postoperative medical treatment were selected and enrolled for this immunoendocrine longitudinal study. Medical treatment consisted of tryptorelinum depot injection, 3.75 mg/month for 24 weeks. Blood samples were collected before the first injection in the early follicular phase, day 2-3 of the cycle, and during medical treatment (every 4 weeks) and follow-up (every 6 months). At the end of the study, we had ten blood samples per patient to evaluate the cytotoxic activity, the number of natural killer cells, and the serum levels of estradiol. Natural killer activity was determined against the K562 cell line by target cell retention of the fluorescent dye carboxyfluorescein diacetate. RESULTS: A positive immunomodulating effect was observed during GnRH agonist administration. In particular, a significant progressive increase in natural killer cell activity was defined within the first 12 weeks of medical treatment; after three injections, we observed the highest values of cytotoxicity, with a median of 7.1 lytic units (range 0.3-14.0; P = .02). Natural cytotoxicity then decreased toward a plateau, which persisted during therapy completation and follow-up, with slight fluctuations. In patients who had recurrence, the values of natural killer cell activity were constantly lower than those in patients with disease-free follow-up, particularly within the first 12 weeks of medical treatment.
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- Effects of pretreatment with long-acting gonadotropin-releasing hormone agonists on pregnancy outcomes in patients with minimal and mild peritoneal endometriosis: A retrospective study of 274 frozen–thawed embryo transfer cycles 2024
- From Clinical Research to Clinical Practice in Obstetrics and Gynecology 2020
- Immune interactions in endometriosis 2011
- Lymphocytes in Endometriosis 2010
- Surgical Preparation of the Patient for In Vitro Fertilization 2008
- Peroxisome proliferator‐activated receptor‐gamma agonist rosiglitazone reduces the size of experimental endometriosis in the rat model 2007
- Constitutive or induced elevated levels of l-carnitine correlate with the cytokine and cellular profile of endometriosis 2005
- In vitro effect of gonadotropin-releasing hormone agonist on natural killer cell cytolysis in women with and without endometriosis 2004
- Management of endometriosis-associated infertility 2003
- Immunology of Endometriosis and Immunotherapy 2003
- Peroxisome proliferator-activated receptor-γ ligand inhibition of RANTES production by human endometriotic stromal cells is mediated through an upstream promoter element 2003
- Immunology and Endometriosis 2003
- Effect of prolonged gonadotropin-releasing hormone agonist therapy on the outcome of in vitro fertilization-embryo transfer in patients with endometriosis 2002
- Current Concepts in the Pathogenesis of Endometriosis 1999
- Immunology of endometriosis 1999
- Immunomodulation in women with endometriosis receiving GnRH agonist 1997
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