Immunology of endometriosis

Riccio, Luiza Gama Coelho; Santulli, Piétro; Marcellin, Louis; Abrão, Maurício Simões; Batteux, Frédéric; Chapron, Charles

doi:10.1016/j.bpobgyn.2018.01.010

Cited by 210 publications

(140 citation statements)

References 85 publications

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“…Endometriosis is a well‐known cause of infertility, although the pathophysiological mechanism by which it causes infertility remains not fully ascertained. Endometriosis is characterized by the growth of ectopic lesions that stimulate infiltration of immune cells and the production of cytokines from endometriotic cells, inducing a progressive and chronic state of inflammation . For this reason, in our study, we examined the possible association between the cytokine profile from cervico‐vaginal washing and endometriosis as a cause of infertility.…”

Section: Discussionmentioning

confidence: 99%

Cervico‐vaginal secretion cytokine profile: A non‐invasive approach to study the endometrial receptivity in IVF cycles

Zanotta

Monasta

Skerk

et al. 2018

American J Rep Immunol

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Several assisted reproductive techniques (ART), including conventional in vitro fertilization (IVF) or intra-cytoplasmic sperm injection (ICSI), are currently available for treatment of infertility. In most ART treatment cycles, one or more good-quality embryos are obtained.Nevertheless, in the last world report, the mean delivery rate per aspiration for fresh cycles reached approximately the 20%, 1 suggesting that a large percentage of good-quality embryos fail to implant.Successful embryo implantation and pregnancy require not only a good-quality embryo, but also a receptive endometrium and effective endometrial-embryonic interactions. 2 This embryo-uterine cross-talk seems to be regulated by several molecules leading to modulation of different cellular functions, such as maternal steroid Problem: Cytokines have a significant role in the process of embryo implantation, trophoblast growth, and differentiation by modulating the immune and endocrine system. The aim of this study was to investigate the profile of a large set of cytokines in the cervico-vaginal washing of women undergoing IVF, to explore the association of these proteins with a good receptive endometrium. Method of study:A cohort of 155 women scheduled for IVF cycle was recruited. All patients were asymptomatic for genitourinary infections and had been screened for chlamydia, mycoplasma, and other bacterial infections. All IVF subjects were treated according to standard clinical and laboratory protocols. A panel of 48 immune factors was analyzed on cervico-vaginal washing, using magnetic bead-based multiplex immunoassays (Bio-Plex, BIO-RAD Laboratories, Milano, Italy). Results:A total of 99 patients reached embryo transfer, of which 31 had a clinical pregnancy. A pattern of four pro-inflammatory immune molecules, IL-12p40, IFN-a, MIF, and MCP3 (P < 0.001), was found significantly up-regulated in the cervico-vaginal fluid of women with clinical pregnancy. A significantly increased expression of IL-9, Gro α , and SDF-1 α (P < 0.05) was observed in the presence of endometriosis, while high levels of IL-13 and L-15 were associated with ovulatory infertility factor (P < 0.05). Conclusion:In this pilot study, we demonstrated that the expression of specific cytokines in the cervico-vaginal washing on the day of oocyte retrieval might have a positive correlation with the potential clinical pregnancy. Therefore, cervico-vaginal secretion cytokine profiling might be a new, non-invasive approach to study the endometrial receptivity in IVF management. K E Y W O R D S cytokines, endometrium, implantation, infertility, IVF, pregnancy How to cite this article: Zanotta N, Monasta L, Skerk K, et al. Cervico-vaginal secretion cytokine profile: A non-invasive approach to study the endometrial receptivity in IVF cycles. Am J Reprod Immunol. 2019;81:e13064. https://doi.

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Section: Discussionmentioning

confidence: 99%

Cervico‐vaginal secretion cytokine profile: A non‐invasive approach to study the endometrial receptivity in IVF cycles

Zanotta

Monasta

Skerk

et al. 2018

American J Rep Immunol

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“…In plasma of women with endometriosis, numerous reports have identified changes in immunology (77)(78)(79)(80)(81)(82)(83)(84)(85), lymphocytes (86), prostaglandins (87), and insulin-like growth factor I (88). That the low natural killer (NK) cell activity in plasma remains low whereas the elevated CA-125 concentrations return to normal after surgical excision of deep endometriosis suggests that the NK cell defect is a cause and the elevated CA-125 a consequence of endometriosis (89).…”

Section: Other Observations Associated With Endometriosismentioning

confidence: 99%

Pathogenesis of endometriosis: the genetic/epigenetic theory

Koninckx

Ussia

Adamyan

et al. 2019

Fertility and Sterility

301

187

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Objective: To study the pathophysiology of endometriosis. Design: Overview of observations on endometriosis. Setting: Not applicable. Patient(s): None. Interventions(s): None. Main Outcome Measure(s): The hypothesis is compatible with all observations. Result(s): Endometriosis, endometrium-like tissue outside the uterus, has a variable macroscopic appearance and a poorly understood natural history. It is a hereditary and heterogeneous disease with many biochemical changes in the lesions, which are clonal in origin. It is associated with pain, infertility, adenomyosis, and changes in the junctional zone, placentation, immunology, plasma, peritoneal fluid, and chronic inflammation of the peritoneal cavity. The Sampson hypothesis of implanted endometrial cells following retrograde menstruation, angiogenic spread, lymphogenic spread, or the metaplasia theory cannot explain all observations if metaplasia is defined as cells with reversible changes and an abnormal behavior/morphology due to the abnormal environment. We propose a polygenetic/polyepigenetic mechanism. The set of genetic and epigenetic incidents transmitted at birth could explain the hereditary aspects, the predisposition, and the endometriosis-associated changes in the endometrium, immunology, and placentation. To develop typical, cystic ovarian or deep endometriosis lesions, a variable series of additional transmissible genetic and epigenetic incidents are required to occur in a cell which may vary from endometrial to stem cells. Subtle lesions are viewed as endometrium in a different environment until additional incidents occur. Typical cystic ovarian or deep endometriosis lesions are heterogeneous and represent three different diseases. Conclusion(s): The genetic epigenetic theory is compatible with all observations on endometriosis. Implications for treatment and prevention are discussed. (Fertil Steril Ò 2019;111:327-40. Ó2018 by American Society for Reproductive Medicine.) El resumen está disponible en Español al final del artículo.

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“…We identified a "pathological" lesion as a site of florid endometriosis or a site of related chronic inflammation according to histopathological criteria defined elsewhere. 20,21 The criteria for interpreting the histological findings were agreed upon before surgery. However, all cases were discussed jointly at the end of the study.…”

Section: Pathologymentioning

confidence: 99%

Real three‐dimensional approach vs two‐dimensional camera with and without real‐time near‐infrared imaging with indocyanine green for detection of endometriosis: A case‐control study

Vizzielli

Cosentino

Raimondo

et al. 2020

Acta Obstet Gynecol Scand

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Introduction The complete surgical removal of endometriosis lesions is not always feasible because some implants may be very small or hidden. The use of intraoperative near‐infrared radiation (NIR) imaging after intravenous injection of indocyanine green (ICG) coupled with robotic technical advances, including three‐dimensional (3D) and high‐resolution vision, might improve detection rates. Material and methods This is a retrospective, multicenter case‐control study (Canadian Task Force classification II‐2) on medical records of women with endometriosis who underwent surgery at the Catholic University of Rome (Controls) and the University of Bologna (Cases) between January 2016 and March 2018. Surgical and post‐surgical data from the procedures were collected. We compared the visual detection rate of endometriotic lesions using near‐infrared radiation imaging after intravenous injection of indocyanine green (NIR‐ICG) in Real 3D (Cases) with the 2D Camera approach (Controls) in symptomatic women with pelvic endometriosis. Results Twenty cases were matched as closely as possible with 27 controls. The numbers of suspected lesions identified both with the white light and the NIR‐ICG approach were 116 and 70 in the Controls (2D) and Cases (3D), respectively. Among them, 16 of 116 controls (13.8%) and 12 of 70 cases (17.1%) were identified using only NIR‐ICG imaging and collected as occult lesions (P = .536). The overall NIR‐ICG lesion identification showed a positive predictive value of 97.8%, negative predictive value of 82.3%, sensitivity of 82.0%, and specificity of 97.9% for the Control group, and a positive predictive value of 100%, negative predictive value of 97.1%, sensitivity of 97.1%, and specificity of 100% for the Case group, confirming that NIR‐ICG imaging is a good diagnostic and screening test (P = .643 and P = .791, according to the Cohen κ tests, respectively for the laparoscopic and robotic groups). Conclusions The few differences observed did not seem to be clinically relevant, making the 2 procedures comparable in terms of the ability to visually detect endometriotic lesions. Further prospective trials are needed to confirm our results.

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Immunology of endometriosis

Cited by 210 publications

References 85 publications

Cervico‐vaginal secretion cytokine profile: A non‐invasive approach to study the endometrial receptivity in IVF cycles

Cervico‐vaginal secretion cytokine profile: A non‐invasive approach to study the endometrial receptivity in IVF cycles

Pathogenesis of endometriosis: the genetic/epigenetic theory

Real three‐dimensional approach vs two‐dimensional camera with and without real‐time near‐infrared imaging with indocyanine green for detection of endometriosis: A case‐control study

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