Murat Berkkanoglu1, Aydin Arici. 1. Division of Reproductive Endocrinology, Department of Obstetrics and Gynecology, Yale University School of Medicine, New Haven, CT 06520-8063, USA.
Abstract
PROBLEM: Accumulating data suggests that aberrant immune responses during retrograde menstruation may be involved in the development of endometriosis. METHOD OF STUDY: The role of immunology in the etiology of endometriosis is reviewed and summarized from the available literature. RESULTS: Immunologic factors may affect a woman's susceptibility to implantation of exfoliated endometrial cells. Immune alterations include increased number and activation of peritoneal macrophages, decreased T cell reactivity and natural killer cell cytotoxicity, increased circulating antibodies, and changes in the cytokine network. CONCLUSION: There is substantial evidence that immunologic factors play a role in the pathogenesis of endometriosis and endometriosis-associated infertility. Decreased natural killer cell cytotoxicity leads to an increased likelihood of implantation of endometriotic tissue. In addition, macrophages and a complex network of locally produced cytokines modulate the growth and inflammatory behavior of ectopic endometrial implants.
PROBLEM: Accumulating data suggests that aberrant immune responses during retrograde menstruation may be involved in the development of endometriosis. METHOD OF STUDY: The role of immunology in the etiology of endometriosis is reviewed and summarized from the available literature. RESULTS: Immunologic factors may affect a woman's susceptibility to implantation of exfoliated endometrial cells. Immune alterations include increased number and activation of peritoneal macrophages, decreased T cell reactivity and natural killer cell cytotoxicity, increased circulating antibodies, and changes in the cytokine network. CONCLUSION: There is substantial evidence that immunologic factors play a role in the pathogenesis of endometriosis and endometriosis-associated infertility. Decreased natural killer cell cytotoxicity leads to an increased likelihood of implantation of endometriotic tissue. In addition, macrophages and a complex network of locally produced cytokines modulate the growth and inflammatory behavior of ectopic endometrial implants.
Authors: Sang Jun Han; Shannon M Hawkins; Khurshida Begum; Sung Yun Jung; Ertug Kovanci; Jun Qin; John P Lydon; Francesco J DeMayo; Bert W O'Malley Journal: Nat Med Date: 2012-07 Impact factor: 53.440