Journal
AMERICAN JOURNAL OF REPRODUCTIVE IMMUNOLOGY
Volume 50, Issue 1, Pages 48-59Publisher
WILEY
DOI: 10.1034/j.1600-0897.2003.00042.x
Keywords
autoimmunity; chemokines; cytokines; endometrium; macrophage; natural killer cell
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PROBLEM: Accumulating data suggests that aberrant immune responses during retrograde menstruation may be involved in the development of endometriosis. METHOD OF STUDY: The role of immunology in the etiology of endometriosis is reviewed and summarized from the available literature. RESULTS: Immunologic factors may affect a woman's susceptibility to implantation of exfoliated endometrial cells. Immune alterations include increased number and activation of peritoneal macrophages, decreased T cell reactivity and natural killer cell cytotoxicity, increased circulating antibodies, and changes in the cytokine network. CONCLUSION: There is substantial evidence that immunologic factors play a role in the pathogenesis of endometriosis and endometriosis-associated infertility. Decreased natural killer cell cytotoxicity leads to an increased likelihood of implantation of endometriotic tissue. In addition, macrophages and a complex network of locally produced cytokines modulate the growth and inflammatory behavior of ectopic endometrial implants.
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