Cytotoxic T-Cells in Peripheral Blood in Women with Endometriosis

 

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Abstract

Aim: The etiology of endometriosis remains unknown, but increasing evidence suggests that immune regulation may be important. Our study aimed to evaluate peripheral blood lymphocyte subpopulations during the menstrual cycle in women with peritoneal and ovarian endometriosis relative to healthy women. Methods: In this study, 65 women with endometriosis (37 in the follicular phase and 28 in the luteal phase of the menstrual cycle) and 61 healthy women (33 in the follicular phase and 28 in the luteal phase) were enrolled. Flow cytometric analysis measured peripheral blood lymphocyte subpopulations. The serum levels of cortisol were also determined. Results: In healthy controls, we detected an increased concentration of cytotoxic (CD8⁺) T cells and activated (HLA-DR) T cells in the luteal phase compared with the follicular phase of the menstrual cycle (p = 0.020 and p = 0.045), whereas no such fluctuation was detected in endometriosis. However, a marked increase in regulatory T-cell concentration in the luteal phase was detected only in endometriosis patients (p = 0.005). Women with endometriosis had higher levels of serum cortisol (p = 0.022), which correlated with the concentration of regulatory T cells (p = 0.048). Conclusions: Women with endometriosis do not exhibit fluctuations in the concentrations of cytotoxic and activated peripheral blood lymphocytes during the menstrual cycle. The marked fluctuation of regulatory T cells detected in endometriosis could be attributed to altered immune response.

Zusammenfassung

Einleitung: Endometriose ist ein häufiges, jedoch komplexes gynäkologisches Syndrom unbekannter Pathogenese, von dem Frauen im gebärfähigen Alter befallen sind. Die Ätiologie der Endometriose bleibt unbekannt, aber immer häufigere Beweise zeigen, dass das Immunsystem dabei eine große Rolle spielt. Unsere Studie zielte darauf ab, die peripheren Blutlymphozytensubpopulationen während des Menstruationszyklus bei Frauen mit Peritoneal- und Ovarialendometriose im Vergleich zu gesunden Frauen zu bewerten. Methoden: Die Studie umfasste 65 Frauen mit Endometriose (37 in der Follikelphase und 28 in der Lutealphase des Menstruationszyklus) und 61 gesunde Frauen (33 in der Follikelphase und 28 in der Lutealphase des Menstruationszyklus). Die Lymphozytensubpopulationen wurden mittels Durchflusszytometrie festgestellt. Der Serumspiegel von Cortisol wurde ebenfalls bestimmt. Ergebnisse: Bei gesunden Probanden fanden wir im peripheren Blut eine erhöhte Konzentration von zytotoxischen (CD8⁺) T-Zellen und aktivierten (HLA-DR) T-Zellen in der Lutealphase gegenüber der Follikelphase des Menstruationszyklus (p = 0,020 und p = 0,045), während keine solche Schwankung in der Endometriose festgestellt wurde. Ein deutlicher Anstieg der regulatorischen T-Zellen-Konzentration in der Lutealphase wurde nur bei Frauen mit Endometriose ermittelt. Frauen mit Endometriose hatten einen höheren Serumspiegel von Cortisol (p = 0,022), der mit der Konzentration von regulatorischen T-Zellen (p = 0,048) korreliert. Schlussfolgerung: Frauen mit Endometriose zeigen keine Konzentrationsschwankungen von zytotoxischen und aktivierten Lymphozyten im peripheren Blut während des Menstruationszyklus. In der Endometriose nachgewiesene Schwankungen von regulatorischen T-Zellen können auf veränderte Immunantwort zurückgeführt werden.

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