Effect of laparoscopic surgery on Th17 cells and Treg cells in patients with endometriosis

Objective To explore the expression of immunoregulatory Th17 cells and Treg cells in patients with endometriosis. Methods Patients with endometriosis in our hospital were selected as an endometriosis group (EMT group) , and patients who underwent laparoscopy in infertility in our hospital during the same period were selected as a normal group (NM group) (n = 56) . There was no difference in general data between the EMT group and the NM group. Flow cytometry, HE staining, qRT-PCR and ELISA were used to analyze the difference of Th17 and Treg cells, endometrial tissue lesions, ROR-γt and Foxp3 mRNA expression in the EMT group and the NM group. To explore the changes of Th17 cells and Treg cells in endometriosis. The results were expressed as ±s and compared by independent sample t-test. Results In the EMT group, the ratio of Th17 to CD4+ T cells was 5.48±2.81, the ratio of Treg to CD4+ T cells was 4.22±1.04, which those in NM group was 2.34±1.01 and 6.14±1.52, respectively. The proportion of Th17 in the EMT group was higher than that in the NM group, and the proportion of Treg in the EMT group was lower than that in the NM group (P < 0.05) . In the EMT group, serum IL-17 levels were (256.38±34.15) pg/ml and IL-22 was (67.48±10.89) pg/ml. In the NM group, the serum IL-17 levels were (198.04±27.59) pg/ml and IL-22 was (43.78±6.92) pg/ml. IL-17 and IL-22 in the EMT group were higher than those in the NM group (P < 0.05) . In the EMT group, the serum IL-10 level was (18.56±4.77) pg/ml, and the TGF-β was (148.28±40.52) pg/ml. In the NM group, the serum IL-10 level was (28.35±6.07) pg/ml, and the TGF-β was (204.78±19.87) pg/ml. IL-10 was lower in the EMT group than in the NM group, and TGF-β was higher in the NM group than in the NM group (P < 0.05) . In the EMT group, the endometrial tissue was irregular in shape, most of the cells were incomplete, damaged or missing, and the inflammatory cells increased and gathered around it. In the NM group, the morphology of the endometrium was regular, and there was no obvious damage or loss of the cells. No increase was found in inflammatory factors around the cells (P < 0.05) . The results of qRT-PCR showed that the level of ROR-γ mRNA in EMT group and NM group were 2.89±0.76 and 1.71±0.26, respectively. The expression of ROR-γ mRNA in the EMT group was higher than that in the NM group. The Foxp3 mRNA level in the EMT group and NM group was 2.25±0.34 and 1.13±0.18, respectively. The expression level of Foxp3 mRNA in EMT group was lower than that in NM group (t = 6.759, P = 0.011) . Conclusion The peripheral blood immunoregulatory cells of patients with endometriosis were imbalanced in Th17/Treg, and the immune regulation disorder was closely related to the occurrence and development of endometriosis. Key words: Laparoscopic surgery; Endometriosis; Treg; Th17