title: CD4(+) CD25(high) Foxp3(+) cells increased in the peritoneal fluid of patients with endometriosis.
abstract: OBJECTIVE
  To evaluate CD4(+) CD25(high) Foxp3(+)  cells and IL-6, IL-10, IL-17, and TGF-β in the peritoneal fluid of women with endometriosis.
  
  
  METHODS
  A total of ninety-eight patients were studied: endometriosis (n = 70) and control (n = 28). First, peritoneal fluid lymphocytes were isolated, and CD4(+) CD25(high)  cells were identified using flow cytometry. Then, RT-PCR was performed to verify Foxp3 expression in these cells. Also, IL-6, IL-10, IL-17, and TGF-β concentration was determined.
  
  
  RESULTS
  Of all the lymphocytes in the peritoneal fluid of women with endometriosis, 36.5% (median) were CD4(+) CD25(high)  compared to only 1.15% (median) in the control group (P < 0.001). Foxp3 expression was similarly elevated in patients with the disease compared to those without (median, 50 versus 5; P < 0.001). IL-6 and TGF-β were higher in endometriosis group (IL-6: 327.5 pg/mL versus 195.5 pg/mL; TGF-β: 340 pg/mL versus 171.5 pg/mL; both P < 0.001). IL-10 and IL-17 showed no significant differences between the two groups.
  
  
  CONCLUSIONS
  The peritoneal fluid of patients with endometriosis had a higher percentage of CD4(+) CD25(high) Foxp3(+)  cells and also higher levels of IL-6 and TGF-β compared to women without the disease. These findings suggest that CD4(+) CD25(high) Foxp3(+)  cells may play a role in the pathogenesis of endometriosis.
authors: Department of Obstetrics and Gynecology, University of Sao Paulo Medical School, Sao Paulo, Brazil. sergiopodgaec@me.com
authors: Sergio
authors: S
authors: Podgaec
authors: Luiz Vicente
authors: LV
authors: Rizzo
authors: Luiz Flavio Cordeiro
authors: LF
authors: Fernandes
authors: Edmund Chada
authors: EC
authors: Baracat
authors: Mauricio Simoes
authors: MS
authors: Abrao
mesh_terms: D000328:Adult; D001202:Ascitic Fluid / Q000276:immunology*; D015704:CD4 Antigens / Q000378:metabolism; D002469:Cell Separation; D004715:Endometriosis / Q000276:immunology*; D005260:Female; D005434:Flow Cytometry; D051858:Forkhead Transcription Factors / Q000378:metabolism; D006801:Humans; D053645:Interleukin-2 Receptor alpha Subunit / Q000378:metabolism; D015850:Interleukin-6 / Q000276:immunology*; D008597:Menstrual Cycle / Q000502:physiology; D050378:T-Lymphocytes, Regulatory / Q000276:immunology*; D016212:Transforming Growth Factor beta / Q000276:immunology*
chemical_list: D015704:CD4 Antigens; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D053645:Interleukin-2 Receptor alpha Subunit; D015850:Interleukin-6; D016212:Transforming Growth Factor beta