Understanding endometriosis from an immunomicroenvironmental perspective
Abstract. Endometriosis, a heterogeneous, inflammatory, and estrogen-dependent gynecological disease defined by the presence and growth of endometrial tissues outside the lining of the uterus, affects approximately 5-10% of reproductive-age women, causing chronic pelvic pain and reduced fertility. A...
Main Authors: | , , , , , , , |
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Format: | Article |
Language: | English |
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Wolters Kluwer
2023-08-01
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Series: | Chinese Medical Journal |
Online Access: | http://journals.lww.com/10.1097/CM9.0000000000002649 |
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author | Dian Fan Xu Wang Zhixian Shi Yuting Jiang Bohao Zheng Lian Xu Shengtao Zhou Yanjie Yin |
author_facet | Dian Fan Xu Wang Zhixian Shi Yuting Jiang Bohao Zheng Lian Xu Shengtao Zhou Yanjie Yin |
author_sort | Dian Fan |
collection | DOAJ |
description | Abstract. Endometriosis, a heterogeneous, inflammatory, and estrogen-dependent gynecological disease defined by the presence and growth of endometrial tissues outside the lining of the uterus, affects approximately 5-10% of reproductive-age women, causing chronic pelvic pain and reduced fertility. Although the etiology of endometriosis is still elusive, emerging evidence supports the idea that immune dysregulation can promote the survival and growth of retrograde endometrial debris. Peritoneal macrophages and natural killer (NK) cells exhibit deficient cytotoxicity in the endometriotic microenvironment, leading to inefficient eradication of refluxed endometrial fragments. In addition, the imbalance of T-cell subtypes results in aberrant cytokine production and chronic inflammation, which contribute to endometriosis development. Although it remains uncertain whether immune dysregulation represents an initial cause or merely a secondary enhancer of endometriosis, therapies targeting altered immune pathways exhibit satisfactory effects in preventing disease onset and progression. Here, we summarize the phenotypic and functional alterations of immune cells in the endometriotic microenvironment, focusing on their interactions with microbiota and endocrine and nervous systems, and how these interactions contribute to the etiology and symptomology of endometriosis. |
first_indexed | 2024-03-12T14:40:53Z |
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institution | Directory Open Access Journal |
issn | 0366-6999 2542-5641 |
language | English |
last_indexed | 2024-03-12T14:40:53Z |
publishDate | 2023-08-01 |
publisher | Wolters Kluwer |
record_format | Article |
series | Chinese Medical Journal |
spelling | doaj.art-3cd05eac80f6480daea6d2c354027bea2023-08-16T07:20:52ZengWolters KluwerChinese Medical Journal0366-69992542-56412023-08-01136161897190910.1097/CM9.0000000000002649202308200-00003Understanding endometriosis from an immunomicroenvironmental perspectiveDian Fan0Xu Wang1Zhixian Shi2Yuting JiangBohao Zheng3Lian Xu4Shengtao Zhou5Yanjie Yin1 Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE and State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, Sichuan 610041, China1 Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE and State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, Sichuan 610041, China1 Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE and State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, Sichuan 610041, China1 Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE and State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, Sichuan 610041, China3 Department of Pathology, West China Second Hospital, Sichuan University, Chengdu, Sichuan 610041, China.1 Department of Obstetrics and Gynecology, Key Laboratory of Birth Defects and Related Diseases of Women and Children of MOE and State Key Laboratory of Biotherapy, West China Second Hospital, Sichuan University and Collaborative Innovation Center, Chengdu, Sichuan 610041, ChinaAbstract. Endometriosis, a heterogeneous, inflammatory, and estrogen-dependent gynecological disease defined by the presence and growth of endometrial tissues outside the lining of the uterus, affects approximately 5-10% of reproductive-age women, causing chronic pelvic pain and reduced fertility. Although the etiology of endometriosis is still elusive, emerging evidence supports the idea that immune dysregulation can promote the survival and growth of retrograde endometrial debris. Peritoneal macrophages and natural killer (NK) cells exhibit deficient cytotoxicity in the endometriotic microenvironment, leading to inefficient eradication of refluxed endometrial fragments. In addition, the imbalance of T-cell subtypes results in aberrant cytokine production and chronic inflammation, which contribute to endometriosis development. Although it remains uncertain whether immune dysregulation represents an initial cause or merely a secondary enhancer of endometriosis, therapies targeting altered immune pathways exhibit satisfactory effects in preventing disease onset and progression. Here, we summarize the phenotypic and functional alterations of immune cells in the endometriotic microenvironment, focusing on their interactions with microbiota and endocrine and nervous systems, and how these interactions contribute to the etiology and symptomology of endometriosis.http://journals.lww.com/10.1097/CM9.0000000000002649 |
spellingShingle | Dian Fan Xu Wang Zhixian Shi Yuting Jiang Bohao Zheng Lian Xu Shengtao Zhou Yanjie Yin Understanding endometriosis from an immunomicroenvironmental perspective Chinese Medical Journal |
title | Understanding endometriosis from an immunomicroenvironmental perspective |
title_full | Understanding endometriosis from an immunomicroenvironmental perspective |
title_fullStr | Understanding endometriosis from an immunomicroenvironmental perspective |
title_full_unstemmed | Understanding endometriosis from an immunomicroenvironmental perspective |
title_short | Understanding endometriosis from an immunomicroenvironmental perspective |
title_sort | understanding endometriosis from an immunomicroenvironmental perspective |
url | http://journals.lww.com/10.1097/CM9.0000000000002649 |
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