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Evaluation of endometrial tissue specific complement activation in women with endometriosis
1Department of Obstetrics and Gynecology, University of Oklahoma Health Sciences Center, Oklahoma City.
Objective:
To determine if endometrial tissue specific complement (C) activation occurs in patients with endometriosis.
Design:
Prospective.
Setting:
University of Oklahoma Health Sciences Center, a tertiary care referral center.
Patients:
Twenty-six women, 9 with endometriosis and 17 without endometriosis.
Interventions:
None.
Main Outcome Measures:
Uterine and ectopic endometria were evaluated by the immunofluorescence assay for the presence of activated products of the initial (C3d) and terminal (C5b-9) C pathway, C3 regulatory proteins (decay-accelerating factor and membrane cofactor protein), and terminal C regulatory proteins (clusterin and vitronectin).
Results:
The initial (C3d) and terminal (C5b-9) C components were deposited on blood vessel walls in uterine and/or ectopic endometria of women with and without endometriosis. In the stromal compartment at both sites, C deposition was colocalized with terminal C inhibitors/cell-cell attachment factors, clusterin and vitronectin on elastic fibers. No specific staining for C proteins was detected on the glandular epithelium of uterine and ectopic endometrial tissues examined. Furthermore, intense staining of endometrial epithelium for C3 regulatory proteins, decay-accelerating factor, and membrane cofactor protein was noted on endometrial glands from women with and without endometriosis.
Conclusions:
Our findings demonstrate a lack of specific deposition of C in the glandular epithelial cells of endometria of women with endometriosis. The localization of C3 regulatory proteins, decay-accelerating factor, and membrane cofactor protein on glandular epithelium may suggest the involvement of intrinsic protective mechanisms on these cells from autologous C attack in vivo.