An abnormal subclinical inflammatory response and disturbances in the immune control system play a significant role in the appearance, progression and persistence of endometrial heterotopias.
OBJECTIVE
To evaluate the role of subclinical inflammatory reactions in the pathogenesis of endometriosis of varying degrees of prevalence based on the analysis of the content of subpopulations of innate immune cells and the level of cytokines in peripheral blood (PB) and peritoneal fluid (PF).
MATERIAL AND METHODS
Phenotyping of lymphocytes using flow cytometry and assessment of the content of immunoregulatory molecules (IL-1β, IL-1Rα, IL-2, IL-4, IL-5, IL-6, IL-7, IL-8, IL-9, IL-10, IL-12(p70), IL-13, IL-15, IL-17A, IFN-γ, TNF-α, MCP-1, MIP-1α, MIP-1β, IP-10, G-CSF, GM-CSF, PDGF-bb, RANTES, Eotaxin, VEGF, FGF basic), TGF-β isoforms, the multiplex method was performed in women with external genital endometriosis (EGE) grades I—II (n= 20) and grades III—IV (n=28) in the PB before surgery and in the PF of the pancreas intraoperatively. The comparison group consisted of 19 women with no genital endometriosis.
RESULTS
The analysis of the subpopulation composition of cells and the level of cytokines in both the PC and the pancreas in women with EGE revealed signs of the presence of an inflammatory process, more pronounced at the local level than at the systemic level. Since identifying non-invasive markers of the prevalence of the process is of great importance, we analyzed the characteristics of correlations between the content of lymphocyte subpopulations and the level of soluble factors in PB. The results of assessing the correlations between the levels of the studied cells and soluble factors in the PB in patients with the early stage of endometriosis indicate dysfunction of the innate immune system, which contributes to the development of heterotopias, and in patients with a common process — the chronicity of the inflammatory process.
CONCLUSIONS
It has been established that in the PB of women with EGE of varying degrees of prevalence of the process, different spectra of multidirectional strong correlations are revealed between the subpopulation composition and the content of soluble immunoregulatory molecules in it, reflecting signs of immune imbalance and inflammation.
