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Decrease in activated regulatory T cell populations in the endometrium during ovulation in endometriosis.

Maya Fujii1, Yukiko Tanaka1, Hiroyuki Okimura1

  • 1Department of Obstetrics and Gynecology, Graduate School of Medical Science, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.

Journal of Reproductive Immunology
|February 9, 2023
PubMed
Summary

Activated regulatory T cells (aTregs) are reduced in women with endometriosis, potentially explaining endometriosis-associated infertility. Understanding these immune cell changes is key to addressing infertility in endometriosis patients.

Keywords:
ChemokineEndometriosisMenstrual cycleRegulatory T lymphocyte

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Area of Science:

  • Immunology
  • Reproductive Medicine
  • Gynecology

Background:

  • Endometriosis is a condition linked to infertility, involving immune system dysregulation.
  • Regulatory T cells (Tregs) play a crucial immunosuppressive role and fluctuate with the menstrual cycle.
  • Activated Tregs (aTregs) are the key immunosuppressive subset, but their role in endometriosis-associated infertility is unclear.

Purpose of the Study:

  • To investigate the function and prevalence of aTregs in endometriosis.
  • To determine the contribution of aTregs to endometriosis-associated infertility.
  • To analyze Treg subset alterations in the endometrium and peritoneal fluid during the menstrual cycle.

Main Methods:

  • Flow cytometry was used to analyze Treg subpopulations.
  • Samples included normal endometrium (NE), eutopic endometrium (EE) from endometriosis patients, normal peritoneal fluid (N-PF), and peritoneal fluid from endometriosis patients (E-PF).
  • Seventy-two women (39 with endometriosis, 33 without) were enrolled.

Main Results:

  • The proportion of aTregs was higher in NE compared to EE during the ovulatory phase (P < 0.05).
  • aTregs were significantly higher in NE than N-PF during ovulatory and secretory phases (P < 0.01 and P < 0.05, respectively).
  • No significant difference in aTreg populations was observed between EE and E-PF. Resting Treg (rTreg) proportions varied in N-PF but not E-PF across the menstrual cycle.

Conclusions:

  • Treg subsets are altered in the endometrium and peritoneal fluid of women with endometriosis.
  • A reduction in aTregs within the eutopic endometrium may be a key mechanism underlying endometriosis-associated infertility.
  • These findings offer insights into the immunological basis of infertility in endometriosis.