The disturbance of TH17-Treg cell balance in adenomyosis

OBJECTIVE: To investigate the balance between regulatory T cells (Treg) and T-helper 17 cells (T(H)17) in peripheral blood and uteri of women with adenomyosis (AM), and to evaluate their potential correlation with dysmenorrhea and CA-125 levels. DESIGN: Laboratory study using human peripheral blood and tissues. SETTING: Academic hospital. PATIENT(S): Forty-five patients with AM (study group) and 25 women without AM (control group). INTERVENTION(S): The peripheral blood and tissues harvested from all groups were subjected to flow cytometry, ELISA, quantitative real-time polymerase chain reaction, and immunohistochemistry. The severity of dysmenorrhea was distinguished by visual analog scale (VAS). MAIN OUTCOME MEASURE(S): T(H)17 and Treg cell frequency, mRNA and protein levels of transcription factors and cytokines in all groups, and their correlation between the T(H)17-Treg ratio and dysmenorrhea severity or CA-125 level. RESULT(S): The disturbance of T(H)17-Treg balance was demonstrated in peripheral circulation and uteri of patients with both diffuse and focal AM, and it correlated positively with dysmenorrhea severity and CA-125. CONCLUSION(S): The findings suggest that T(H)17-Treg imbalance may play a crucial role in the immunopathogenesis of AM, and may be thus a potential target of AM therapy. CLINICAL TRIAL REGISTRATION NUMBER: ChiCTR-CCC-13003500.