Approaches to the search for immunological markers of endometriosis and the degree of its prevalence

Introduction. The innate immune system plays a leading role in the initiation and progression of external genital endometriosis (EGE) lesions.

Aim. Тo analyze the content of subpopulations of immunocompetent cells and the level of cytokines in peripheral blood (PB) and peritoneal fluid (PF) to identify the most informative indicators as non-invasive markers of EGE and the degree of its prevalence. Materials and methods. Phenotyping of lymphocytes by flow cytometry and assessment of cytokine content by multiplex method (27-plex panel) were performed in women with EGE of I–II degree (n = 20) and III–IV degree of prevalence (n = 28) in the PB before surgery and in the PF intraoperatively. The comparison group included 19 women without EGE.

Results. In the PB of women with EGE, regardless of the degree of prevalence of the process, an increase in the content of leukocytes, neutrophils, NF/LF index and a decrease in the content of lymphocytes, a change in the ratio of classical and intermediate monocytes, a low content of T-reg were found, a direct relationship was found between the content of T-regulatory cell subpopulations in the PB and in the PF. For the diagnosis of EGE of I-II degree of prevalence, the best parameters of significance were obtained for the content of MCP-1, MIP-1β in the PF, and for EGE of III-IV degree of prevalence – IL-6, IL-8. In the EGE I-II subgroup of patients, feedback was found between regulatory NK cells and cytokines, which may reflect an immune imbalance at the systemic level. In the EGE III-IV subgroup of patients, direct medium-strength connections were found between CD200+ cells and a wide range of cytokines, which reflects the chronicity of the inflammatory process.

Conclusions. Prospects for further research into EGE of various degree of prevalence are associated precisely with the formation of panels of non-invasive markers.

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