The CCL17‐CCR4 axis between endometrial stromal cells and macrophages contributes to the high levels of IL‐6 in ectopic milieu
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Endometrial stromal cells and macrophages communicate via the CCL17-CCR4 axis, leading to elevated IL-6 levels in the ectopic environment of endometriosis.
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Abstract
Endometriosis is a chronic inflammatory disease characterized by the elevation of proinflammatory cytokines, such as IL-6, in the peritoneal fluid. However, the precise mechanism of the highly elevated IL-6 levels in ectopic milieu remains unclear. The aim of this study was to investigate whether the cross talk between endometrial stromal cells (ESCs) and macrophages contributes to the elevated IL-6 production. Samples of endometrium and ectopic tissues were obtained from patients with or without endometriosis. The peripheral blood samples were collected from healthy volunteers. Enzyme-linked immunosorbent assay (ELISA) was for IL-6 levels in peritoneal fluid and cell culture supernatant. In-Cell Western assay was used for protein expression of CCL17 and phosphorylation levels of ERK, JNK, and P38. Immunohistochemistry was performed on normal, eutopic endometrium and ectopic tissues to analyze CCL17 expression. Flow cytometry was applied to detect the expression of CCR4, IL-6, and the phosphorylation levels of NF-κB. Patients with endometriosis have higher levels of IL-6 in peritoneal fluid compared to the control. The co-culture of ESCs and macrophages produce more IL-6 than cultured alone, respectively. The eutopic endometrium had significantly higher expression of CCL17 compared to normal endometrium, and the ectopic tissues had the highest expression. IL-6 induced CCL17 secretion in ESCs via activating JNK signaling pathway, CCL17 upregulated the expression of its receptor CCR4 on macrophages. Furthermore, CCL17-CCR4 axis subsequently led to excessive IL-6 production in macrophages by activating NF-κB. These findings suggest that the cross talk between ESCs and macrophages promotes the expression of CCL17 in ESCs and CCR4 on macrophages, which contributes to the high levels of IL-6 in ectopic milieu.
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Cited by (11)
- Endometriosis as a risk factor for age-related macular degeneration: A nationwide population-based study 2025
- Synergy between Th1 and Th2 responses during endometriosis: A review of current understanding 2023
- An Update on the Multifaceted Role of NF-kappaB in Endometriosis 2022
- Strategies for modelling endometrial diseases 2022
- Macrophages Protect Endometriotic Cells Against Oxidative Damage Through a Cross-Talk Mechanism 2022
- Role of inflammation in benign gynecologic disorders: from pathogenesis to novel therapies† 2021
- G-CSF and IL-6 may be involved in formation of endometriosis lesions by increasing the expression of angiogenic factors in neutrophils 2021
- Niclosamide suppresses macrophage-induced inflammation in endometriosis† 2020
- Estrogen receptor β upregulates CCL2 via NF-κB signaling in endometriotic stromal cells and recruits macrophages to promote the pathogenesis of endometriosis 2019
- Pro-endometriotic niche in endometriosis 2018
- The extracellular signal‐regulated kinase 1/2 triggers angiogenesis in human ectopic endometrial implants by inducing angioblast differentiation and proliferation 2017
Source provenance
- europepmc
- last seen: 2026-06-04T01:30:01.192114+00:00
- openalex
- last seen: 2026-06-04T00:00:01.174412+00:00
- pubmed
- last seen: 2026-05-13T22:20:37.704673+00:00
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