Endometriosis and suppression of the characteristics of the cytotoxic immune response

Abstract

Immune dysregulation plays a key role in the pathogenesis of endometriosis, facilitating the survival and implantation of heterotopic endometrial cells outside the uterine cavity. The aim of this study was to evaluate the functional status and cytotoxic characteristics of immune cells in women with endometriosis of varying severity. The study included patients with gynecologically confirmed endometriotic lesions and a control group of healthy women. Study methods included flow cytometry to assess lymphocyte subpopulation composition, determination of natural killer (NK) cell and cytotoxic T lymphocyte activity, and measurement of regulatory cytokine levels. The study revealed a significant suppression of cytotoxic cell functional activity. A decrease in the expression of surface activation markers and granular proteins, perforin and granzyme B, was observed in NK cells, which correlated with the prevalence of endometriotic heterotopias. The identified immunodeficiency was accompanied by an increase in suppressor cytokine levels, which locally inhibited an effective clearance response. The study concludes that selective suppression of the cytotoxic immune system is an important pathogenic factor in the progression of endometriosis. These findings support the inclusion of immunomodulatory approaches in a comprehensive treatment strategy for patients with this condition.