Immune Aspects of Endometriosis: Relevance of the Uterine Mucosal Immune System

Rier SE, S. E. Rier, Sherry E. Rier, Grant R. Yeaman, G. R. Yeaman, Yeaman GR
Seminars in reproductive endocrinology · 1997 · vol. 15(03) , pp. 209–220 · doi:10.1055/s-2008-1068750 · PMID:9383829 · W2067495911
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⚙ AI-generated summary by claude@2026-06, 2026-06-11 ⓘ

This review examines leukocyte populations, cytokines, and their hormonal regulation in uterine and ectopic endometrium to understand the immune system's role in endometriosis pathogenesis.

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⚙ AI-generated deep summary by claude@2026-07, 2026-07-09 · read from full text ⓘ

This paper is a 2008 review examining immune dysregulation as a proposed mechanism for endometriosis, focusing on how decreased clearance of endometrial cells and abnormal cytokine production by peritoneal leukocytes may allow ectopic implantation and growth. It discusses uterine mucosal immunity, emphasizing hormonally regulated cytokine signaling between uterine epithelial and stromal cells, leukocytes, and the conceptus, and reviews leukocyte populations, cytokines, and cytokine receptors reported in both uterine and ectopic endometrium. The review highlights studies on hormonal regulation of cytokine secretion by uterine and peritoneal cell populations and describes data on cytokine effects on endometrial proliferation, while noting that these findings are framed as proposed roles rather than definitive causal mechanisms. This paper is centrally about endometriosis — specifically, it reviews how the uterine mucosal immune system and cytokine signaling relate to endometriosis pathogenesis.

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Abstract

Endometriosis is classically defined as the growth of endometrial cells at sites outside the uterus. It is a common disease characterized by infertility, chronic pain and adhesion formation. Immune dysregulation, evidenced by decreased clearance of endometrial cells and aberrant production of cytokines by peritoneal fluid leukocytes, has been proposed as a mechanism which allows implantation and growth of ectopic endometrium. Cytokines are primary components of intercellular signaling between uterine epithelial and stromal cells, leukocytes, and the developing conceptus. Because their production is regulated by sex hormones, cytokines are well-placed to play a key role in the extensive tissue remodeling required to accommodate menstruation, implantation and pregnancy. Understanding this specialized hormonally-responsive mucosal immune system within the uterus will be critical to understanding the potential importance of the immune system in the pathogenesis of endometriosis. In this review, highlights of studies describing leukocyte populations, cytokines and cytokine receptors in uterine and ectopic endometrium and their proposed role in the regulation of immune processes and endometrial growth are presented, followed by a review of current data on immune aspects of endometriosis. Studies directed at investigating the hormonal regulation of cytokine secretion by uterine and peritoneal cell populations, and the effect of cytokines on endometrial proliferation, should provide a more complete understanding of their potential role in normal uterine growth and in the pathogenesis of endometriosis.
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Abstract

Endometriosis is classically defined as the growth of endometrial cells at sites outside the uterus. It is a common disease characterized by infertility, chronic pain and adhesion formation. Immune dysregulation, evidenced by decreased clearance of endometrial cells and aberrant production of cytokines by peritoneal fluid leukocytes, has been proposed as a mechanism which allows implantation and growth of ectopic endometrium. Cytokines are primary components of intercellular signaling between uterine epithelial and stromal cells, leukocytes, and the developing conceptus. Because their production is regulated by sex hormones, cytokines are well-placed to play a key role in the extensive tissue remodeling required to accommodate menstruation, implantation and pregnancy. Understanding this specialized hormonally-responsive mucosal immune system within the uterus will be critical to understanding the potential importance of the immune system in the pathogenesis of endometriosis. In this review, highlights of studies describing leukocyte populations, cytokines and cytokine receptors in uterine and ectopic endometrium and their proposed role in the regulation of immune processes and endometrial growth are presented, followed by a review of current data on immune aspects of endometriosis. Studies directed at investigating the hormonal regulation of cytokine secretion by uterine and peritoneal cell populations, and the effect of cytokines on endometrial proliferation, should provide a more complete understanding of their potential role in normal uterine growth and in the pathogenesis of endometriosis.

Keywords

Endometriosis - endometrium - leukocytes - cytokines - interleukin - interferon - tumor necrosis factor - transforming growth factor - receptors - immune system

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Condition tags

endometriosisinfertility

MeSH descriptors

Cytokines Endometriosis Endometrium Peritoneal Diseases Ascitic Fluid Ascitic Fluid Ascitic Fluid Cytokines Endometriosis Endometriosis Endometriosis Endometrium Endometrium Female Humans Immunity, Mucosal Leukocytes Leukocytes Peritoneal Diseases Peritoneal Diseases

Citation neighborhood

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. [ expand to 2 hops ] — adds papers reached through this work's immediate citers/citees. Heavier; up to 60 extra dots.

Cited by (31)

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