Immunology of endometriosis.

M Ulukus, Murat Ulukuş, A Arici, Aydın Arıcı
Minerva ginecologica · 2005 · vol. 57(3) , pp. 237–48 · PMID:16166933 · W2402976146
article OA: closed CC0 ⤵ 59 in-corpus citations
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Endometriosis pathogenesis involves altered cell-mediated and humoral immunity, including increased peritoneal macrophages and decreased T/NK cell cytotoxicity, promoting ectopic endometrial cell survival and growth.

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Abstract

Endometriosis is classically described as the presence of both endometrial glandular and stromal cells outside the uterine cavity, mainly in the pelvis. The pathogenesis of this enigmatic disorder still remains controversial despite extensive research. Although multiple theories have been put forth to explain the pathophysiology and pathogenesis of endometriosis, the retrograde menstruation theory of Sampson is the most widely accepted. However, since retrograde menstruation occurs in most of the reproductive age women, it is clear that there must be other factors which may contribute to the implantation of endometrial cells and their subsequent development into endometriotic disease. There is substantial evidence to support that the alterations in both cell-mediated and humoral immunity contribute to the pathogenesis of endometriosis. Increased number and activation of peritoneal macrophages, decreased T cell and natural killer (NK) cell cytotoxicities are the alterations in cellular immunity and result in inadequate removal of ectopic endometrial cells from the peritoneal cavity. Moreover, increased levels of several cytokines and growth factors which are secreted by either immune and endometrial cells seem to promote implantation and growth of ectopic endometrium by inducing proliferation and angiogenesis. In addition to the impaired capacity of the immune cells to mediate endometrial cell removal, inherent resistance of the ectopic endometrial cells against immune cells is another interesting concept in the pathogenesis of endometriosis. Endometriosis has also been considered to be an autoimmune disease, since it is often associated with the presence of autoantibodies, other autoimmune diseases, and possibly with recurrent immune-mediated abortion.

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Condition tags

endometriosis

MeSH descriptors

Cytokines Endometriosis Autoantibodies Autoantibodies B-Lymphocytes B-Lymphocytes Cytokines Endometriosis Female Humans Killer Cells, Natural Killer Cells, Natural T-Lymphocytes T-Lymphocytes

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