Endometriosis: an inflammatory disease with a Th2 immune response component

TLDR

The immune response’s role in endometriosis has been investigated, but its precise contribution remains unclear. The study aimed to analyze how Th1 and Th2 cytokine patterns interact in endometriosis. The authors measured IL‑2, IL‑4, IL‑10, TNF‑α, and IFN‑γ by flow cytometry in blood and peritoneal fluid of 98 patients with or without endometriosis. Patients with endometriosis showed elevated peritoneal IL‑10 and IFN‑γ, altered cytokine ratios, and a Th2‑skewed profile, supporting that endometriosis is an inflammatory disease with a Th2 component.

Abstract

Efforts have been made to correctly characterize the role of the immune response in endometriosis. The objective of this study was to analyse the interaction between Th1 and Th2 immune response patterns and endometriosis by evaluating a panel of cytokines. Between January 2004 and November 2005, 98 patients, classified into two groups according to the histologically confirmed presence (Group A) or absence of endometriosis (Group B), were evaluated. Interleukins (IL) 2, 4 and 10, tumour necrosis factor-alpha and interferon-gamma (IFN-gamma) were measured by flow cytometry in the peripheral blood and peritoneal fluid of all patients. IFN-gamma and IL-10 levels were significantly higher in the peritoneal fluid of patients with endometriosis compared to those without endometriosis (P < 0.05). There was a significant alteration in the IL-4/IFN-gamma (P < 0.001), IL-4/IL-2 (P = 0.006), IL-10/IFN-gamma (P < 0.001) and the IL-10/IL-2 ratios (P < 0.001) in the peritoneal fluid of patients with endometriosis, with a predominance of IL-4 and IL-10, reflecting a shift towards Th2 immune response despite the increase in IFN-gamma concentrations. Endometriosis is an inflammatory disease involving a possible shift towards Th2 immune response component, as demonstrated by the relative increase in cytokines characteristic of this pattern of immune response.