The disturbance of TH17-Treg cell balance in adenomyosis

Objective: To investigate the balance between regulatory T cells (Treg) and T-helper 17 cells (TH17) in peripheral blood and uteri of women with adenomyosis (AM), and to evaluate their potential correlation with dysmenorrhea and CA-125 levels. Design: Laboratory study using human peripheral blood and tissues. Setting: Academic hospital. Patient(s): Forty-five patients with AM (study group) and 25 women without AM (control group). Intervention(s): The peripheral blood and tissues harvested fromall groupswere subjected to flowcytometry, ELISA, quantitative real-time polymerase chain reaction, and immunohistochemistry. The severity of dysmenorrhea was distinguished by visual analog scale (VAS). Main Outcome Measure(s): TH17 and Treg cell frequency, mRNA and protein levels of transcription factors and cytokines in all groups, and their correlation between the TH17-Treg ratio and dysmenorrhea severity or CA-125 level. Result(s): The disturbance of TH17-Treg balance was demonstrated in peripheral circulation and uteri of patients with both diffuse and focal AM, and it correlated positively with dysmenorrhea severity and CA-125. Conclusion(s): The findings suggest that TH17-Treg imbalance may play a crucial role in the immunopathogenesis of AM, and may be thus a potential target of AM therapy. (C) 2014 by American Society for Reproductive Medicine.