Potential New Biomarker Could Help Assess Endometriosis Severity

High protein levels of 'perforin 1' and 'MICA' in women with advanced stage endometriosis.

Key Points

Highlights: 

• The levels of proteins called 'perforin 1' and 'MICA' are high in women with endometriosis, and are associated with the severity of the disease.

Importance:

• Perforin 1' and 'MICA' protein levels can be used as a biomarker for assessing disease severity in endometriosis.

What’s done here:

• Researchers analyzed the levels of granulysin, MICA, and perforin 1 in the serum and peritoneal fluid of 44 women with endometriosis.
• Fourty-three women with other benign gynecological disorders were used as controls for comparison.

Key results:

• The levels of perforin were significantly higher in the serum and peritoneal fluid of women with endometriosis.
• The levels were even higher in women with more advanced disease.
• The levels of perforin 1 positively correlated with the rASRM adhesion scores.
• The levels of perforin 1 were also high in the serum of women with ovarian endometrioma.
• The levels of MICA were elevated in the peritoneal fluid of women with late-stage endometriosis.
• The levels of MICA were elevated in the serum in the follicular phase compared to the luteal phase.

Limitations

More research is needed to confirm these findings. 

Lay Summary

High levels of two proteins, 'perforin 1' and 'major histocompatibility complex class I-related chain A (MICA)' are associated with the stage of endometriosis, found a new study published in the scientific journal Immunological Investigations. They could therefore be used as a biomarker to assess the severity of the disease. 

“Future studies should validate this finding and explore its therapeutic role in endometriosis,” the authors of the study said.

In order to test the possible link between molecules that play a role in immune surveillance such as granulysin, MICA, and perforin, and clinical features in infertile women with endometriosis, a team of researchers led by Dr. M Y Ardianta Widyanugraha from the Department of Obstetrics and Gynecology in the Faculty of Medicine at Universitas Airlangga in Surabaya, Indonesia analyzed 87 infertile women undergoing laparoscopy for diagnosis.  Of these, 44 had endometriosis while 43 had other benign gynecological disorders. 

The researchers found that women with endometriosis had significantly higher levels of perforin in their serum and peritoneal fluid compared to the others. This was especially the case in patients with more advanced disease. 

Moreover, the levels of perforin 1 in both the serum and peritoneal fluid positively correlated with the patients’ revised American Society for Reproductive Medicine (rASRM) adhesion scores. 

High levels of perforin 1 were also seen in the serum of patients with ovarian endometrioma. 

Finally, the levels of MICA were also elevated in the peritoneal fluid of women with late-stage endometriosis and the levels of MICA were elevated in the serum in the follicular phase compared to the luteal phase.

Research Source: https://pubmed.ncbi.nlm.nih.gov/39589023/