Cellular immune environment in endometrial polyps

Endometrial polyps in premenopausal women demonstrate a range of immunologic disturbances, including mast cell and regulatory T-cell infiltration. These likely contribute to symptoms of infertility and abnormal bleeding.

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Authors

Tania El-Hamarneh, M.D., M.Phil., Alison Hey-Cunningham, Ph.D., Marina Berbic, Ph.D., Moamar El-Jefout, Ph.D., Ian S. Fraser, M.D., Kirsten I. Black, M.B.B.S., Ph.D.

Volume 100, Issue 5, Pages 1364-1372, November 2013

Abstract

Objective:

To investigate the immune environment of endometrial polyps (EPs).

Design:

Prospective case-control study.

Setting:

Teaching hospital and university research laboratory.

Patient(s):

Reproductive-age women undergoing hysteroscopy dilation and curettage for benign indications. Samples were collected from women with (n = 23) and without (n = 40) EPs.

Intervention(s):

Endometrial samples were immunohistochemically stained with antibodies against mast cells (MCs) and regulatory T cells (Tregs).

Main outcome measure(s):

Tryptase+, chymase+, and c-Kit+ MCs and Foxp3+ Tregs were quantified in EPs and polyp-adjacent, polyp-distant, and control endometrium.

Result(s):

Densities of all MC types were highly significantly increased in EPs compared with adjacent, distant, and control endometrium. Chymase+ and c-Kit+ MCs were increased in density in adjacent compared with control endometrium. c-Kit+ MCs were also increased in distant compared with control endometrium. Foxp3+ Treg density was increased in EPs compared with distant and control endometrium and decreased in distant compared with control endometrium.

Conclusion(s):

This study provides novel insights into localized disturbances in the cellular immune environment within EPs consistent with EPs being inflammatory lesions associated with MC overactivity. Tregs are likely to be recruited to EPs in an attempt to suppress the inflammatory process due to the greatly increased presence of MCs. These immunologic disturbances are likely to be involved in the causation of abnormal bleeding and infertility in premenopausal women with EPs, and their role in the pathophysiology requires further research.

Read the full text at: http://www.fertstert.org/article/S0015-0282(13)00751-6/fulltext


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Fertility and Sterility

Editorial Office, American Society for Reproductive Medicine

Fertility and Sterility® is an international journal for obstetricians, gynecologists, reproductive endocrinologists, urologists, basic scientists and others who treat and investigate problems of infertility and human reproductive disorders. The journal publishes juried original scientific articles in clinical and laboratory research relevant to reproductive endocrinology, urology, andrology, physiology, immunology, genetics, contraception, and menopause. Fertility and Sterility® encourages and supports meaningful basic and clinical research, and facilitates and promotes excellence in professional education, in the field of reproductive medicine.

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