A higher number of exhausted local PD1+, but not TIM3+, NK cells in advanced endometriosis
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Advanced endometriosis is associated with a higher frequency of exhausted PD-1+ NK cells in peritoneal fluid, but not peripheral blood, compared to fertile controls.
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Abstract
Endometriosis (EMT) is a chronic inflammatory disease characterized by the presence and growth of endometrial-like glandular epithelial and stromal cells outside the uterus. Natural Killer (NK) cell dysfunction/exhaustion has been shown in patients with EMT. In this case-control study, we compared the frequency of exhausted PD-1 or TIM-3 positive NK cells in peripheral blood (PB) and peritoneal fluid (PF) of women with advanced endometriosis to control fertile women. PB and PF were collected from women aged 25–40 who underwent the laparoscopic procedure, including 13 stages III/IV endometriosis and 13 control samples. Multicolor flowcytometry was used to compare the frequency of PD-1 or TIM-3 positive NK (CD3−CD56+) cells in PB and PF of two groups. We demonstrated a higher percentage of PD-1+ NK cells in the peritoneal fluid of patients with endometriosis rather than controls (P-value = 0.039). This significance was related to stage IV of endometriosis (P-value = 0.047). We can not show any significant difference in the number of PD-1 or TIM-3 positive NK cells in peripheral blood. Our results suggest a local exhausted NK cell response in endometriosis that can be a leading factor in the endometriosis pathogenesis.
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Cited by (11)
- The Microbiota–Endometriosis Axis: An Immune–Endocrine Integration Model and Emerging Therapeutic Targets 2026
- Emerging Mechanisms of NK Cell Dysfunction in Endometriosis: The Role of Autophagy, Metabolism, Cytokines, Exosomes, and Trogocytosis 2025
- PD-1 Expression in Endometriosis 2025
- Endometriosis and autoimmunity 2025
- Endometriosis as an immune-mediated disease: pathogenetic mechanisms and therapeutic strategies 2025
- Reframing Endometriosis: Interplay of NETs, Macrophages, and Lymphocytes at the Crossroads of Disease Progression, Infertility, and Malignant Transformation 2025
- Dysfunction of natural killer cells promotes immune escape and disease progression in endometriosis 2025
- Balancing Decidualization, Autophagy, and Cellular Senescence for Reproductive Success in Endometriosis Biology 2025
- Immune Checkpoints in Endometriosis—A New Insight in the Pathogenesis 2024
- Emerging strategies for the treatment of endometriosis 2024
- Systemic inflammatory indices as a non-invasive grading modality for endometriosis: a comparative study versus exploratory laparoscopy 2024
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