The regulation of immunoglobulin production by B cells in patients with endometriosis.

Nineteen patients with endometriosis and 26 control infertile patients were included in the study. All patients were undergoing laparoscopy as part of their infertility evaluations. The study was conducted on sterile heparinized peripheral blood and peritoneal fluid. The age range was 20 to 37 years for both groups. Mononuclear cells were isolated on Ficoll-hypaque density gradients. T cells, B cells, and T cell subsets were identified by the specific immunobead rosette technique. Mononuclear cells 1 x 10(6) were cultured in Roswell Park Memorial Institute medium and stimulated in the presence or absence of pokeweed mitogen. Immunoglobulin production was measured by an enzyme-linked immunosorbent assay. Increased amounts of immunoglobulin (Ig) IgG and IgA were demonstrated in the peritoneal cell cultures (P less than 0.05), whereas peripheral blood cell cultures showed only an increase in IgG in patients with endometriosis (P less than 0.05). There was an increase in the number of T cells, B cells, and the ratio of CD4/CD8 lymphocytes in endometriosis compared with control patients (P less than 0.005) in both peritoneal fluid and peripheral blood. This study suggests that immunoglobulin production by the "activated" B cells may be regulated by the increased presence of T cells, specifically the helper cells (CD4) in endometriosis.