Role of macrophages in the immunopathogenesis of adenomyosis

In: EUREKA: Health Sciences · 2022 · pp. 50–56 · doi:10.21303/2504-5679.2022.002644 · W4308674430
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This study found increased CD68+ macrophages in the myometrium of adenomyosis patients, indicating an immunopathological process and a proinflammatory shift in macrophage phenotypes.

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This prospective study investigated the immunopathogenesis of adenomyosis by analyzing uterine tissue samples from twenty women with first-degree disease and fifteen healthy controls. Researchers utilized immunohistochemistry to quantify CD68+ and CD163+ macrophages, revealing a significant increase in macrophage numbers within the myometrium of patients, particularly around perivascular regions. The findings indicated a proinflammatory shift characterized by a distorted CD68 to CD163 ratio, suggesting that these immune alterations form the basis for endometrioid heterotopia formation. This paper is centrally about adenomyosis — specifically examining the role of macrophage polarization and inflammatory markers in its pathophysiology.

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Abstract

The aim of the research: to study pathophysiological mechanisms of adenomyosis development by determining the role of macrophages in the uterine microenvironment. Materials and methods: a prospective study has been conducted on 35 women. There were 20 (57.1 %) who had adenomyosis of I degree. The control group consisted of 15 (34.3 %) gynecologically healthy women. The patients underwent general clinical, instrumental (ultrasound, hysteroscopy) examinations. Fragments of the uterine wall obtained by hysterorectoscopy were used for morphological study. The method of immunohistochemical determination of CD68+ and CD163+ macrophages was used to analyze the characteristics of phenotypic equivalents of M1 and M2 macrophages in uterine tissue samples. Results: The increase in the number of macrophages in the myometrium of patients with adenomyosis revealed in this study, which is found in large numbers in the areas of infiltration of the stroma of myometrial cells in close association with the perivascular region, can be regarded as the basis of the mechanism for the formation of endometrioid heterotopia. Furthermore, distortion of the CD68/CD163 ratio of macrophages is characterized by proinflammatory shift. Conclusions: The study's main result is an increase in the quantitative indicators of CD68+ macrophages associated with adenomyosis, which indicates an immunopathological process in adenomyosis.
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Materials and methods

a prospective study has been conducted on 35 women. There were 20 (57.1 %) who had adenomyosis of I degree. The control group consisted of 15 (34.3 %) gynecologically healthy women. The patients underwent general clinical, instrumental (ultrasound, hysteroscopy) examinations. Fragments of the uterine wall obtained by hysterorectoscopy were used for morphological study. The method of immunohistochemical determination of CD68+ and CD163+ macrophages was used to analyze the characteristics of phenotypic equivalents of M1 and M2 macrophages in uterine tissue samples.

Results

The increase in the number of macrophages in the myometrium of patients with adenomyosis revealed in this study, which is found in large numbers in the areas of infiltration of the stroma of myometrial cells in close association with the perivascular region, can be regarded as the basis of the mechanism for the formation of endometrioid heterotopia. Furthermore, distortion of the CD68/CD163 ratio of macrophages is characterized by proinflammatory shift.

Conclusions

The study's main result is an increase in the quantitative indicators of CD68+ macrophages associated with adenomyosis, which indicates an immunopathological process in adenomyosis. Downloads

References

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MHR: Basic Science of Reproductive Medicine, 25 (1), 5–16. doi: https://doi.org/10.1093/molehr/gay049 Downloads Published Versions - 2022-07-31 (Version of Record 1.0) Issue Section License Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals. Authors, who are published in this journal, agree to the following conditions: 1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal. 2. 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adenomyosis

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Papers in the corpus that this work cites (lower rings, blue) and that cite this one (upper rings, green). Dot size scales with the paper's in-corpus citation count — bigger dot = more influential within the endo/adeno field. Click a dot to open that paper. Outer rings show 2-hop neighbours — papers reached through the immediate citers/citees. [ collapse to 1-hop ]

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