Hum. Reprod. Advance Access published online on January 18, 2007
Human Reproduction, doi:10.1093/humrep/del516
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© The Author 2007. Published by Oxford University Press on behalf of the European Society of Human Reproduction and Embryology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Endometriosis: an inflammatory disease with a Th2 immune response component
1 Department of Obstetrics and Gynecology, Teaching Hospital 2 Department of Immunology, Institute of Biomedical Sciences, University of São Paulo, São Paulo, Brazil 3 RDO Diagnósticos Médicos, São Paulo, Brazil
4 To whom correspondence should be addressed at: Department of Obsterics and Gynecology, Teaching Hospital, University of São Paulo, Rua João Moura 627, cj.23, Jardim América, São Paulo, SP 05412-911, Brazil. Tel.: 55 11 3081 7003; E-mail: spodgaec{at}uol.com.br
BACKGROUND: Efforts have been made to correctly characterize the role of the immune response in endometriosis. The objective of this study was to analyse the interaction between Th1 and Th2 immune response patterns and endometriosis by evaluating a panel of cytokines.
METHODS: Between January 2004 and November 2005, 98 patients, classified into two groups according to the histologically confirmed presence (Group A) or absence of endometriosis (Group B), were evaluated. Interleukins (IL) 2, 4 and 10, tumour necrosis factor-alpha and interferon-gamma (IFN-gamma) were measured by flow cytometry in the peripheral blood and peritoneal fluid of all patients.
RESULTS: IFN-gamma and IL-10 levels were significantly higher in the peritoneal fluid of patients with endometriosis compared to those without endometriosis (P < 0.05). There was a significant alteration in the IL-4/IFN-gamma (P < 0.001), IL-4/IL-2 (P = 0.006), IL-10/IFN-gamma (P < 0.001) and the IL-10/IL-2 ratios (P < 0.001) in the peritoneal fluid of patients with endometriosis, with a predominance of IL-4 and IL-10, reflecting a shift towards Th2 immune response despite the increase in IFN-gamma concentrations.
CONCLUSIONS: Endometriosis is an inflammatory disease involving a possible shift towards Th2 immune response component, as demonstrated by the relative increase in cytokines characteristic of this pattern of immune response.
Key words: cytokine/endometriosis/interleukin/interferon/tumor necrosis factor
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