Macrophages in patients with recurrent endometrial polyps could exacerbate Th17 responses

Abstract

Endometrial polyps (EPs) are outgrowths in the endometrium with unknown etiology. The fact that EPs can often recur after surgical removal suggests that EPs are not induced by random events but by continuous or recurrent processes in patients. We previously demonstrated that the risk of EP development was positively associated with overactive Th17 responses. However, the requirements of Th17 upregulation are yet unclear. Here, we recruited 26 women with symptomatic EP and 24 without EP, and peripheral mononuclear cells were harvested for the examination of circulating immunity. Compared to controls without EP, the patients with symptomatic EP presented significantly elevated levels of monocyte activation. The circulating monocytes from patients secreted higher levels of tumor necrosis factor (TNF), interleukin (IL)-1β, IL-6 and IL-23 directly ex vivo and with LPS stimulation. In memory CD4 T cells, monocytes were not required for IL-17 expression, but the presence of activated monocytes significantly increased the secretion of IL-17. In naive CD4 T cells, activated monocytes were required for significant IL-17 secretion and RORC transcription. Interestingly, the monocytes from EP individuals were significantly more potent in promoting Th17 differentiation from naive CD4 T cells than the monocytes from controls. Furthermore, we showed that monocyte-mediated Th17 differentiation required the secretion of TNF, IL-1β and IL-6. Together, this study demonstrated activated monocytes supported Th17 inflammation in patients with EP.

The relationship between anti mullerian hormone level and endometrial polyp frequency in patients with polycystic ovary syndrome

“…The difference in hormone levels between the two groups was significant with p >0.001, which shows a significant difference in the AMH level of the two groups. Other studies have concluded that AMH and PCOS can be a good differentiator between endometrial polyp sufferers and non-affected people (16,19). As in this research, a clear difference was seen between the level of this hormone in endometrial polyp and healthy subjects.…”

“…Although the serum AMH level cannot accurately predict the risk level of endometrial polyps in women with PCOS, different studies have found different threshold levels (from AMH 3.8 to 5 ng/cc) to be sensitive for diagnosis (16,19,20). In a study conducted by Munro (20) on 60 PCOS cases and a control group, there was a significant difference in the average AMH level in patients with 14.7 and 3.14 in the control group.…”

Circulating PD1+Vδ1+γδ T Cell Predicts Fertility in Endometrial Polyp Patients of Reproductive-Age

“…Although reproductive immunology has achieved great progresses over past decades ( 14 – 16 ), and the view “immune suppression” during pregnancy has been widely accepted as one of important conceptions in the field of reproductive immunology ( 15 , 16 ), further insights into immunity features of women of reproductive-age still remains to be fully illuminated. Although previous study showed that various immune cells, including natural killer (NK) cells ( 17 ), macrophages ( 9 ), and CD4 + T cells ( 18 ), play key roles in maintaining normal pregnancy at term, however, how peripheral immunity affects pregnancy ability is yet to be fully understood. Therefore, in this prospective study, we focused on characterizing immune profiles/phenotypes of circulating immune cells, such as CD4 + T cells, CD8 + T cells, NK cells, and γδ T cells.…”

“…Black et al (2013) reported that inflammatory lesion associated with infiltrated mast cells in EP tissue plays important roles in inducing local immune disturbances (8). Moreover, the circulating monocytes of EP patients can secrete high levels of TNF, IL-1b, IL-6, and IL-23, which could impair fertility (9). In addition, endometrial inflammation (10,11) or infection of chlamydia trachomatis (12) are also prone to induce AUB and subfertility (10).…”

Changes in Peripheral Blood as Manifestation of Disorders in the Mononuclear Phagocyte and Platelet System in Endometriosis

“…Исходя из результатов нашего исследования, можно заметить такой факт, что количество моноцитов в периферической крови при сочетании эндометриоза с другими патологиями женской репродуктивной системы (в том числе заболеваниями эндометрия) было значимо выше. Роль макрофагов в становлении патологии эндометрия активно обсуждается исследователями, которые показывают патогенетическую значимость этой клеточной популяции при полипах эндометрия, гиперплазии эндометрия и других заболеваниях [6,7]. Интересно, что для возникновения маточно-перитонеального рефлюкса имеются некоторые факторы риска, среди которых упоминаются различные заболевания женской репродуктивной системы [8].…”