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The paper studied immunological mechanisms underlying adenomyosis combined with endometrial hyperplasia in women of reproductive age, focusing on NK-cell cytotoxic activity as a marker of immune system dysregulation. Using data from 135 participants, the authors compared three phased treatment approaches over 3, 6, and 12 months: progestogen alone, a GnRH agonist alone, or combined hormonal therapy plus an intramuscular immunomodulator followed by additional hormonal phases. The key finding was that benign uterine pathology (including combined endo-myometrial involvement) was associated with reduced NK-cell cytotoxic index, and the proposed comprehensive regimen was evaluated in terms of its effects on immune parameters over time. This paper’s results and immune assessments are limited by the lack of detailed reporting in the provided text. This paper is centrally about endometriosis and/or adenomyosis — specifically adenomyosis (and combined endometrial hyperplasia) and its immune mechanisms involving NK-cell cytotoxicity.
Abstract
The objective: to study the role of immunological mechanisms in the development of adenomyosis with endometrial hyperplasia in women of reproductive age and the phased introduction of an integrated hormonal and immunostimulating therapy. Patients and methods. The authors investigated the effect of hormone therapy on the immune system of women with adenomyosis and endometrial hyperplasia: We evaluated the influence of hormone therapy 135 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: group i - 45 women using a progestogen (6 months); II – 45 women who took agonist of gonadotropin-relesing hormone (a-GnRH) (6 months) III – 45 women who received complex therapy involving a-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course – 6 months), then in the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25день. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. NK (natural killer) activity was estimated by the method of Hamaoka modification N.T. Rekowа. Results.We studied the role of immune system in the pathogenesis of adenomyosis, endometrial hyperplasia and endometrial and combined pathology of endo- and myometrium in women of reproductive age by assessing the cytotoxic activity of NK-cells, since this component determines its oversight role in the dynamics. Identified new pathogenic mechanisms in the development of benign pathology of the uterus due to the dysfunction of the immune system, especially expressed in terms of reduction of cytotoxic index of NK-cells. Conclusion. Developed a comprehensive phased hormone therapy for women of reproductive age with combined benign uterus pathology, including immunomodulator and the estimation of influence on parameters of immune status in the dynamics of observation. Key words: NK-cells, benign uterine pathology, comprehensive hormone therapy, Progestogens, -GnRH.
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- The role of immune mechanisms in the development of benign uterus pathology
The role of immune mechanisms in the development of benign uterus pathology
HEALTH OF WOMAN. 2016.5(111):30–32; doi 10.15574/HW.2016.111.30
The role of immune mechanisms in the development of benign uterus pathology
Benyuk V. A., Altibaeva D. M., Goncharenko V. N., Kurochka V. V.
A.A. Bogomolets National Medical University, Kiev
Kyiv maternity hospital № 3
The objective: to study the role of immunological mechanisms in the development of adenomyosis with endometrial hyperplasia in women of reproductive age and the phased introduction of an integrated hormonal and immunostimulating therapy.
Patients and methods. The authors investigated the effect of hormone therapy on the immune system of women with adenomyosis and endometrial hyperplasia: We evaluated the influence of hormone therapy 135 women of reproductive age with adenomyosis in combination with endometrial hyperplasia: group i – 45 women using a progestogen (6 months); II – 45 women who took agonist of gonadotropin-relesing hormone (a-GnRH) (6 months) III – 45 women who received complex therapy involving a-GnRH during the first 6 months and immunomodulator intramuscularly every other day No. 20, with subsequent use of tablets of 0.15 g of 1 times a week (course – 6 months), then in the next 6 months was used progestogen in the second phase of the menstrual cycle from 16 to 25день. Evaluation of indicators of health status were performed after 3, 6 and 12 months of therapy. NK (natural killer) activity was estimated by the method of Hamaoka modification N.T. Rekowа.
Results.We studied the role of immune system in the pathogenesis of adenomyosis, endometrial hyperplasia and endometrial and combined pathology of endo- and myometrium in women of reproductive age by assessing the cytotoxic activity of NK-cells, since this component determines its oversight role in the dynamics. Identified new pathogenic mechanisms in the development of benign pathology of the uterus due to the dysfunction of the immune system, especially expressed in terms of reduction of cytotoxic index of NK-cells.
Conclusion. Developed a comprehensive phased hormone therapy for women of reproductive age with combined benign uterus pathology, including immunomodulator and the estimation of influence on parameters of immune status in the dynamics of observation.
Key words: NK-cells, benign uterine pathology, comprehensive hormone therapy, Progestogens, -GnRH.
REFERENCES
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2. Tatarchuk TF, Burlaka OV, Korіnna KO. 2005. Medical therapy of endometrial processes Drugs and life: 100–101.
3. Afonso JS. 2005. Adenomiosis: pathohysiology, diagnosis and treatment (review). Vu Hysteroscopy at Fri. 12(2):1
4. Kiselev OI, Mazurov VI, Malinovskaya VV. 2002. The definition of interferon status as a method of assessment of immunoreactivity at different forms of pathology. Manual for doctors: 25.
5. Kiselev OI, Tkachenko BI, Ershov FI. 2005. Interferon Induction: new approaches to the creation of functional inducers. Medical academic journal 5(2):76-95.
6. Cycloferon in clinical practice. Methodical recommendations for doctors. 2002:44.
7. Aden P, Quereda F, Campos A, Gomez-Torres MJ, Velasco I, Gutierrez M. 2002, Oct. Use of intraperitoneal interferon alpha-2b therapy after conservative surgery for endometriosis and postoperative medical treatment with depot gonadotropin-releasing hormone analog: a randomized clinical trial. Fertil Steril. 78(4):705-11. http://dx.doi.org/10.1016/S0015-0282(02)03330-7
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