New horizons in endometriosis and immunity

Immune mechanisms gain wider importance in endometriosis

Key Points

Highlights :

• Changes in systemic and local immunity, including functional disturbances of effector and antigen-presenting cells have a pivotal role in endometriosis.

Importance:

• Immune system derangements are highly sophisticated in patients with endometriosis, a multidisciplinary approach should be put forward.

What's done here :

• This is a comprehensive literature overview conducted using several databases with keywords related to endometriosis and immunity.
• Co-inhibitory immune checkpoints that might be related to endometriosis pathophysiology were outside the focus.

Main key features :

• Modifications in cells’ activity caused by immune checkpoints may lead to serious immune system disturbances in endometriosis.
• Effector cell activity inhibitions either low or high, against endometrial implants and disturbances in the antigen-presenting process, are the pivotal points.

Lay Summary

Academicians led by Dorota Suszczyk from Lublin, Poland have published their recent comprehensive narrative review on immunity and endometriosis in International Journal of Molecular Sciences. Recent evidence points to the importance of co-inhibitory immune checkpoints which could be related to endometriosis mechanisms that we were unaware of.

The authors have made a comprehensive literature overview conducting search via the PubMed/Medline/Scopus database, with a combination of medical subject headings terms, and keywords related to immunity and endometriosis.

Endometriosis seems to be associated with modifications both in systemic and local immunity, with additional functional derangements in effector and antigen-presenting cells. Upregulation and even downregulation in the expression of immune checkpoint receptors and ligands of immune cells may lead to serious derangements in the immune defense and balance of endometriosis patients.

The increase in immune checkpoints in peritoneal cells could be associated with lowering the effector function of T lymphocytes, resulting in anergy, and apoptosis. The disturbed antigen-presenting capacity finally results in inefficient clearance of endometrium tissue implants from the peritoneum in women with endometriosis.

Endometriosis must be handled via multidisciplinary cooperation including pharmacotherapy, diet, and psychological assistance. The impact of immune checkpoint-related therapy may improve clinical management by salvaging the physiology of effector immune cells by reviving the antigen-presenting process.

The authors conclude that extensive studies are needed to reveal the potential clinical impact of immune checkpoints in endometriosis patients.

Research Source: https://pubmed.ncbi.nlm.nih.gov/38892453/