title: A novel pilot study of endometrial stromal cells and immune cell populations in sentinel uterine-draining lymph nodes during the menstrual cycle and in endometriosis.
abstract: Recent studies suggest that changes in certain uterine immune cell populations in endometrium of women with endometriosis are likely to precede changes at ectopic sites. This preliminary study is a first look into the function of uterine-draining lymph nodes (LNs) during the menstrual cycle and in the presence of endometriosis. Paraffin-embedded obturator LNs were obtained from women with (n = 7, mean age 44.3) and without (n = 9, mean age 38.4) endometriosis, who had undergone hysterectomy for cervical or ovarian cancer and in whom LN involvement was not detected. Immunohistochemical staining for endometrial stromal cells and a range of immune cell populations was performed. The CD10+ endometrial stromal cells were detected in uterine-draining LNs throughout the menstrual cycle with numbers peaking during menstruation. The inflammatory process of menstruation was also associated with increased numbers of CD3+, CD4+, Foxp3+, DC-Sign+, CD68+, CD20+, CD79+, and plasma cells. In endometriosis, CD10+ endometrial stromal cells were further increased in numbers, but CD3+, CD4+, DC-Lamp+, FoxP3+, and plasma cells were reduced. This study indicates that efficient immunological responses may be required to contain shed endometrial fragments within the draining uterine LNs thus preventing their further dissemination with establishment of ectopic lesions at distant sites.
authors.affiliation: 1Department of Obstetrics, Gynaecology and Neonatology, Queen Elizabeth II Research Institute for Mothers and Infants, The University of Sydney, Sydney, New South Wales, Australia.
authors.forename: Marina
authors.initials: M
authors.lastname: Berbic
authors.forename: Cecilia H M
authors.initials: CH
authors.lastname: Ng
authors.forename: Kirsten
authors.initials: K
authors.lastname: Black
authors.forename: Robert
authors.initials: R
authors.lastname: Markham
authors.forename: Peter
authors.initials: P
authors.lastname: Russell
authors.forename: Anthony
authors.initials: A
authors.lastname: Basten
authors.forename: Ian S
authors.initials: IS
authors.lastname: Fraser
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Hey-Cunningham
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D018450:Disease Progression; D004715:Endometriosis / Q000276:immunology* / Q000473:pathology / Q000503:physiopathology; D004717:Endometrium / Q000276:immunology* / Q000473:pathology; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D008198:Lymph Nodes / Q000276:immunology* / Q000473:pathology; D008597:Menstrual Cycle / Q000276:immunology*; D008875:Middle Aged; D016612:Paraffin Embedding; D010865:Pilot Projects; D010950:Plasma Cells / Q000276:immunology* / Q000473:pathology; D017154:Stromal Cells / Q000276:immunology* / Q000473:pathology
chemical_list: D015415:Biomarkers
keywords: endometriosis; immunology; lymph nodes; lymphatic spread; menstrual cycle