Evaluation of M1 and M2 macrophages in ovarian endometriomas from women affected by endometriosis at different stages of the disease

Abstract

Endometriosis is an estrogen-dependent disease defined by the presence and growth of functional endometrial-like tissue, glands and stroma, outside the uterine cavity. Macrophages are broadly classified into pro-inflammatory M1 macrophages, and M2 macrophages, which have selective anti-inflammatory and pro-fibrotic activities and are able to induce immunotolerance and angiogenesis. Based on these elements, the aim of our study was to evaluate CD14⁺CD68⁺CD197⁺CD80⁺ M1 and CD14⁺CD68⁺CD163⁺CD206⁺ M2 macrophages in tissue samples from ovarian endometriomas of women affected by endometriosis at different stages of the disease. For each patient, we collected a biological sample of the cyst (ovarian endometriomas for cases and ovarian functional cyst for controls) during laparoscopy. We found that the number of both M1 and M2 macrophages was significantly higher in endometriosis group than controls, regardless of stage (p < .0001 for each stage versus controls). Moreover, our data analysis shows a trend in progressive decrease of M1 macrophages from stage I to stage IV; on the contrary, M2 macrophages show a specular trend compared to M1 macrophages, with a progressive increase from stage I to stage IV. This may contribute to the pro-inflammatory microenvironment in the early stages of the disease, and to the pro-fibrotic activity of the advanced stages.

摘要

子宫内膜异位症是一种雌激素依赖性疾病, 定义为子宫腔外有功能性子宫内膜样组织、腺体和间质的存在和生长。巨噬细胞大致分为促炎的M1巨噬细胞和M2巨噬细胞, 它们具有选择性的抗炎和促纤维化活性, 并能诱导免疫耐受和血管生成。本研究的目的是检测不同分期子宫内膜异位症患者卵巢组织标本中CD14^＋CD68^＋CD197^＋CD80^＋ M1和CD14⁺CD68⁺CD163⁺CD206⁺ M2巨噬细胞。我们在腹腔镜检查术中收集了囊肿的生物样本(卵巢子宫内膜异位症为病例组, 卵巢功能性囊肿为对照组)。我们发现无论其分期如何(与对照组相比, 各阶段均P<0.0001), 子宫内膜异位症组的M1和M2巨噬细胞的数量均显著高于对照组。此外, 我们的数据分析显示, M1巨噬细胞从I期到IV期有进行性减少的趋势, 相反, M2巨噬细胞与M1巨噬细胞相比呈相反的趋势, 从I期到IV期有逐渐增加的趋势, 这可能与疾病早期的促炎微环境和晚期的促纤维化活动有关。

The Chinese abstracts are translated by Prof. Dr. Xiangyan Ruan and her team: Beijing Obstetrics and Gynecology Hospital, Capital Medical University, Beijing 100026, China.

Keywords:

• Endometriosis
• macrophages
• endometriomas
• inflammation
• immunity

Acknowledgements

The research project was developed and supported by the Ph.D. program of the University of Messina (CIP n. 2014.IT.05.SFOP.014/3/10.5/9.2.02/0006 - CUP n. G47E16000030009).

Disclosure statement

The authors have no proprietary, financial, professional or other personal interest of any nature in any product, service or company. The authors alone are responsible for the content and writing of the paper.