The natural killer activity of peritoneal fluid lymphocytes is decreased in women with endometriosis

Didier J. Oosterlynck; Christel Meuleman; Mark Waer; Michel Vandeputte; Philippe R. Koninckx

doi:10.1016/s0015-0282(16)55224-8

Endometriosis Pathophysiology

The natural killer activity of peritoneal fluid lymphocytes is decreased in women with endometriosis

Oosterlynck DJ, Meuleman C, Waer M, Vandeputte M, Koninckx PR

Published August 1992 Fertility and Sterility, 58(2), 290-295

DOI 10.1016/s0015-0282(16)55224-8 PMID 1633893

RRM Academy Synopsis

Peritoneal natural killer cell activity is lower in endometriosis

A 1992 prospective study of 44 women in Belgium found that natural killer cell activity in the peritoneal fluid was lower in women with endometriosis. Activity fell as the disease stage rose. The defect was more pronounced in the follicular phase than after ovulation.

Key Findings

Of 44 women, 23 had endometriosis (stage I in 9, stage II in 8, stages III and IV in 6) and 21 had none.
Natural killer activity of peritoneal fluid cells was decreased in women with endometriosis compared with women without it (ANOVA, P = 0.0002).
In blood, activity in women with endometriosis decreased to 74.3% of the control activity and correlated with disease severity (ANOVA, P = 0.002).
Total activity in the fluid and activity per mL of fluid stayed decreased and correlated with severity (ANOVA, P = 0.004 and 0.005).
In women with endometriosis, fluid cell activity was higher in 10 women after ovulation than in 13 women in the follicular or late luteal phase (Student's t-test, P = 0.005).

Interpretation

The study compared women grouped by what laparoscopy found. It reports a link between natural killer activity and disease stage. The women had laparoscopy for infertility, pain, or tubal sterilization at one Belgian hospital. The authors write that this lower activity can be the reason for impaired clearance of endometrial cells that reach the pelvic cavity. Smears showed no significant difference in macrophage share between the groups (Student's t-test, P = 0.3). The authors removed macrophages in samples from three women without endometriosis and say more experiments are needed in women with the disease.

RRM Context

RRM looks for the biological cause of endometriosis. In women with endometriosis, the authors found lower local immune activity in the follicular phase. Cycle timing matters to the disease, and cycle charting records it.

Our editorial summary of this paper, not the article's abstract.

Abstract

Objective

To investigate the local natural killer (NK) activity of the peritoneal fluid mononuclear cells (PFMC).

Design and Participants

In a prospective way, the NK activity (K562-assay) was measured in peripheral blood (PB) and peritoneal fluid (PF) of 44 women who underwent a laparoscopy for infertility and/or pain at the University Hospital of Gasthuisberg, Leuven, Belgium.

Main Outcome Measures

The NK activity of peripheral blood mononuclear cells and PFMC, the number and concentration of PFMC, the percentage of lymphocytes versus macrophages by May-Grünwald-Giemsa staining and the estradiol and progesterone concentration of the PF were correlated together and with the severity of endometriosis.

Results

We demonstrated that there is a significant NK activity in PF and that this activity is decreased in women with endometriosis. This defect was more pronounced in the follicular phase of the cycle compared with the postovulatory phase. In PB of the same 44 women, the decreased NK activity correlated with the severity of the disease. This confirms our previous report on another 34 women.

Conclusions

The NK activity is decreased in women with endometriosis and correlated significantly with the severity of the disease in both the PB and PF of women with endometriosis.

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Endometriosis Explained: Diagnosis, Excision Surgery, and the RRM Approach

Topics

Endometriosis › Pathophysiology › Inflammation and Immunology · Genetics and Immunology › Reproductive Immunology › Implantation Immunology · General Gynecology › Pelvic Pain › Chronic Pelvic Pain

Didier J. Oosterlynck, Christel Meuleman, Mark Waer, Michel Vandeputte, Philippe R. Koninckx

D Oosterlynck, C Meuleman, M Waer, M Vandeputte, P Koninckx

PMID 1633893 1633893 DOI 10.1016/s0015-0282(16)55224-8 10.1016/s0015-0282(16)55224-8 Oosterlynck et al. 1992, Oosterlynck 1992

Keywords

Ascitic Fluid/pathology, Endometriosis/immunology, Female, Humans, Killer Cells, Natural/immunology/pathology, Leukocytes, Mononuclear/immunology/pathology, Menstrual Cycle/immunology, Prospective Studies

The natural killer activity of peritoneal fluid lymphocytes is decreased in women with endometriosis

Peritoneal natural killer cell activity is lower in endometriosis

Key Findings

Interpretation

RRM Context

Abstract

Read the guide

Topics

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Keywords