Functional and phenotypic alterations in peritoneal macrophages from patients with early and advanced endometriosis

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Peritoneal macrophages in endometriosis patients showed increased numbers and IL-1 production, with decreased HLA-DR+ and increased NBT+ cells, suggesting systemic alterations across disease stages.

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This study examined whether peritoneal macrophage (pMO) alterations occur across endometriosis stages and whether 6 months of hormonal treatment affects these cells, by quantifying pMO number, HLA-DR expression (pMO DR+), nitro-blue tetrazolium reduction (pMO NBT+), and IL-1 and PGE2 production in patients with early (stages I/II) and advanced (stages III/IV) disease, with additional analysis in treated patients receiving danazol or GnRHa. The authors found significantly increased pMO numbers in both early and advanced endometriosis (highest in early), decreased pMO DR+ percentages, increased pMO NBT+ percentages, and enhanced IL-1 production in both stages, while PGE2 was unchanged in early disease but was ~100-fold higher than controls in advanced disease. Post-hormonal treatment, pMO number and pMO NBT+ remained similar to early endometriosis and pMO DR+ returned toward the normal range, but overall the study concluded that hormonal treatment did not reverse the pMO changes. This paper is centrally about endometriosis—functional and phenotypic alterations in peritoneal macrophages across early and advanced endometriosis and how they respond to danazol or GnRHa treatment.

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Abstract

The aim of this study was to elucidate whether peritoneal macrophage (pMO) alterations are a generalized feature in all stages of endometriosis and the effect of hormonal treatment on this leukocyte population. For this purpose we quantified the number of pMO, the expression of HLA-DR antigen (pMO DR+), percentages of pMO that reduced nitro-blue tetrazolium (pMO NBT+), and interleukin-1 (IL-1) and prostaglandin E2 (PGE2) production by pMO from patients with early (stages I/II) and advanced (stages III/IV) endometriosis, we also analyzed some of these properties in pMO from patients which had been treated for 6 months with 800 mg/day of Danazol or gonadotropin releasing hormone agonist (GnRHa). We found that there were a significant increase of the pMO number in both types of patients, though the highest values were obtained in early endometriosis (p < 0.001). Percentages of pMO DR+ were decreased in all patients (p < 0.01) while percentages of pMO NBT+ were significantly increased. Production of IL-1 by early and advanced endometriosis pMO were considerably enhanced. PGE2 release was not altered in early endometriosis pMO but, in advanced endometriosis, pMO PGE2 levels were 100-fold higher than control values. In posttreatment patients, the number of pMO and percentage of pMO NBT+ were similar to early endometriosis patients, though the percentage of pMO DR+ was within the normal range. We conclude that the pMO population, as well as IL-1 and PGE2 production, were altered in all stages of endometriosis, and that these changes could be involved in the pathogenesis of endometriosis and associated infertility. Hormonal treatments do not reverse the pMO changes.
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Abstract. The aim of this study was to elucidate whether peritoneal macrophage (pMO) alterations are a generalized feature in all stages of endometriosis and the effect of hormonal treatment on this leukocyte population. For this purpose we quantified the number of pMO, the expression of HLA-DR antigen (pMO DR+), percentages of pMO that reduced nitro-blue tetrazolium (pMO NBT+), and interleukin-1 (IL-1) and prostaglandin E2 (PGE2) production by pMO from patients with early (stages I/II) and advanced (stages III/IV) endometriosis, we also analyzed some of these properties in pMO from patients which had been treated for 6 months with 800 mg/day of Danazol or gonadotropin releasing hormone agonist (GnRHa). We found that there were a significant increase of the pMO number in both types of patients, though the highest values were obtained in early endometriosis (p<0.001). Percentages of pMO DR+ were decreased in all patients (p<0.01) while percentages of pMO NBT+ were significantly increased. Production of IL-1 by early and advanced endometriosis pMO were considerably enhanced. PGE2 release was not altered in early endometriosis pMO but, in advanced endometriosis, pMO PGE2 levels were 100-fold higher than control values. In post-treatment patients, the number of pMO and percentage of pMO NBT+ were similar to early endometriosis patients, though the percentage of pMO DR+ was within the normal range. We conclude that the pMO population, as well as IL-1 and PGE2 production, were altered in all stages of endometriosis, and that these changes could be involved in the pathogenesis of endometriosis and associated infertility. Hormonal treatments do not reverse the pMO changes. Similar content being viewed by others Author information Authors and Affiliations Additional information Received: 3 September 1997 / 29 December 1997 Rights and permissions About this article Cite this article Raiter-Tenenbaum, A., Barañao, R., Etchepareborda, J. et al. Functional and phenotypic alterations in peritoneal macrophages from patients with early and advanced endometriosis . Arch Gynecol Obstet 261, 147–157 (1998). https://doi.org/10.1007/s004040050214 Issue date: DOI: https://doi.org/10.1007/s004040050214

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Condition tags

endometriosis

MeSH descriptors

Endometriosis Macrophages Adult Danazol Danazol Dinoprostone Dinoprostone Endometriosis Endometriosis Estrogen Antagonists Estrogen Antagonists Female Gonadotropin-Releasing Hormone Gonadotropin-Releasing Hormone HLA-DR Antigens HLA-DR Antigens Humans Interleukin-1 Interleukin-1 Macrophage Activation

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