Characterization of endometriosis-associated immune cell infiltrates (EMaICI)

Claudia Scheerer, Petia Bauer, Vito Chiàntera, Vito Chiantera, Jalid Sehouli, Andreas M. Kaufmann, Andreas Kaufmann, Sylvia Mechsner
Archives of gynecology and obstetrics · 2016 · vol. 294(3) , pp. 657–664 · doi:10.1007/s00404-016-4142-6 · PMID:27358184 · W2474155584
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⚙ AI-generated summary by claude@2026-06+body, 2026-06-12 ⓘ

Endometriosis-associated immune cell infiltrates (EMaICI), comprised of T lymphocytes, macrophages, and B lymphocytes, were found in all endometriosis types, with highest frequency in peritoneal and ovarian endometriosis.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-09 · read from full text ⓘ

This study characterized endometriosis-associated immune cell infiltrates (EMaICI) in histologically proven endometriotic tissue from 60 premenopausal women, using immunohistochemistry on paraffin-embedded samples with antibodies to CD3, CD4, CD8, CD45RO, CD25, CD56, CD68, and CD20. EMaICI were detected in all endometriosis types, comprising T lymphocytes (CD3+), helper T cells (CD4+), cytotoxic T cells (CD8+), memory T cells (CD45RO+), macrophages (CD68+), and B lymphocytes (CD20+), with negative staining for regulatory T cells (CD25+ high, FoxP3+) and NK cells (CD56+). The highest frequency and largest infiltrate size were observed in peritoneal endometriosis and ovarian endometriosis, whereas occurrence was lower and smaller in myometrium from adenomyosis. This paper is centrally about endometriosis — it defines and compares the immune cell infiltrates (EMaICI) across endometriosis subtypes and includes adenomyosis for comparison.

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Abstract

Objective To identify and characterize endometriosis-associated immune cell infiltrates (EMaICI). Furthermore, to define occurrence and size of EMaICI in various types of endometriosis.

Methods

Immune cells were characterized in samples of 60 premenopausal women with histological proven endometriosis. Therefore, immunohistochemical staining with monoclonal antibodies for CD3, CD4, CD8, CD45RO, CD25, CD56, CD68, and CD20 on sections of paraffin-embedded endometriotic tissue was performed.

Results

EMaICI were observed in all the types of endometriosis, and characterized as T lymphocytes (CD3+), helper T lymphocytes (CD4+), cytotoxic T lymphocytes (CD8+), antigen-experienced T lymphocytes”memory cells” (CD45RO+), macrophages (CD68+), and B lymphocytes (CD20+). The maximum frequency of EMaICI and their distribution per endometriotic lesion (EML) was observed in peritoneal endometriosis (pEM) and in ovarian endometriosis (Ov. EM). In myometrium from adenomyosis (M/AM), EMaICI occurrence was lower and smaller in size in comparison with EMaICI seen in other forms of endometriosis. EMaICI were negative for regulatory T cells (CD25+ high, FoxP3+) and natural killer cells (NK cells, CD56+).

Conclusion

Numerous and brisk EMaICI comprising several types of immune cells in all endometriosis forms suggest acute immunological reactions within the microenvironment of endometriosis lesions. Similar content being viewed by others Abbreviations - AM: - Adenomyosis - CD: - Cluster of differentiation - DIE: - Deep infiltrating rectovaginal endometriosis - EDT: - Endometriosis disease theory - EM: - Endometriosis - EMaICI: - Endometriosis-associated immune cell infiltrates - EML: - Endometriotic lesions - EN1/pEM: - Endometrium from patients with peritoneal EM - EN2/AM: - Endometrium from adenomyosis - EN3k/UM: - Endometrium from uterus myomatosus, used as control - ICI: - Immune cell infiltrates - IHC: - Immunohistochemistry - M/AM: - Myometrium from adenomyosis - M/UM: - Myometrium from myomatosus uterus, used as control - NK: - Natural killer cells - NLP: - Non-lesional peritoneum, used as control - NLO: - Non-lesional ovarium, used as control - Ov. EM: - Ovarian endometriosis - p EM: - Peritoneal endometriosis - p: - Proliferative phase - s: - Secretory phase

References

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Fertil Steril 66(1):81–89 Isaacson KB, Xu Q, Lyttle CR (1991) The effect of estradiol on the production and secretion of complement component 3 by the rat uterus and surgically induced endometriotic tissue. Fertil Steril 55(2):395–402 Author information Authors and Affiliations Corresponding author Ethics declarations Conflict of interest All authors of this work declare that they have no conflict of interest. Ethical issues All procedures performed in this study involving human samples were in accordance with the ethical standards of the Charité ethics committee. The study was approved by the IRB of Charité ethics committee (EA) and informed consent was obtained from all patients. Rights and permissions About this article Cite this article Scheerer, C., Bauer, P., Chiantera, V. et al. Characterization of endometriosis-associated immune cell infiltrates (EMaICI). Arch Gynecol Obstet 294, 657–664 (2016). https://doi.org/10.1007/s00404-016-4142-6 Received: Accepted: Published: Issue date: DOI: https://doi.org/10.1007/s00404-016-4142-6

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Lymphocytes Macrophages Ovarian Diseases Adult Endometriosis Endometriosis Female Humans Immunohistochemistry Lymphocytes Macrophages Middle Aged Ovarian Diseases Ovarian Diseases

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