Endometriosis: an inflammatory disease with a Th2 immune response component.
BACKGROUND
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.


METHODS
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.


RESULTS
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.


CONCLUSIONS
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.
Podgaec
S
S
Department of Obstetrics and Gynecology, Teaching Hospital, University of São Paulo, São Paulo, Brazil. spodgaec@uol.com.br
Abrao
M S
MS
Dias
J A
JA
Rizzo
L V
LV
de Oliveira
R M
RM
Baracat
E C
EC
D000293:Adolescent; D000328:Adult; D001202:Ascitic Fluid / Q000737:chemistry; D004715:Endometriosis / Q000276:immunology*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis; D016753:Interleukin-10 / Q000032:analysis; D007376:Interleukin-2 / Q000032:analysis; D015847:Interleukin-4 / Q000032:analysis; D018417:Th1 Cells / Q000276:immunology; D018418:Th2 Cells / Q000276:immunology*; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis
C508609:IL10 protein, human; C508598:IL4 protein, human; D007376:Interleukin-2; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D007371:Interferon-gamma