Cellular immune environment in endometrial polyps.
OBJECTIVE
To investigate the immune environment of endometrial polyps (EPs).


METHODS
Prospective case-control study.


METHODS
Teaching hospital and university research laboratory.


METHODS
Reproductive-age women undergoing hysteroscopy dilation and curettage for benign indications. Samples were collected from women with (n = 23) and without (n = 40) EPs.


METHODS
Endometrial samples were immunohistochemically stained with antibodies against mast cells (MCs) and regulatory T cells (Tregs).


METHODS
Tryptase+, chymase+, and c-Kit+ MCs and Foxp3+ Tregs were quantified in EPs and polyp-adjacent, polyp-distant, and control endometrium.


RESULTS
Densities of all MC types were highly significantly increased in EPs compared with adjacent, distant, and control endometrium. Chymase+ and c-Kit+ MCs were increased in density in adjacent compared with control endometrium. c-Kit+ MCs were also increased in distant compared with control endometrium. Foxp3+ Treg density was increased in EPs compared with distant and control endometrium and decreased in distant compared with control endometrium.


CONCLUSIONS
This study provides novel insights into localized disturbances in the cellular immune environment within EPs consistent with EPs being inflammatory lesions associated with MC overactivity. Tregs are likely to be recruited to EPs in an attempt to suppress the inflammatory process due to the greatly increased presence of MCs. These immunologic disturbances are likely to be involved in the causation of abnormal bleeding and infertility in premenopausal women with EPs, and their role in the pathophysiology requires further research.
Department of Obstetrics, Gynaecology and Neonatology, Queen Elizabeth II Research Institute for Mothers and Infants, University of Sydney, Sydney, New South Wales, Australia.
Tania
T
El-Hamarneh
Alison J
AJ
Hey-Cunningham
Marina
M
Berbic
Moamar
M
Al-Jefout
Ian S
IS
Fraser
Kirsten
K
Black
D000328:Adult; D015415:Biomarkers / Q000032:analysis; D016022:Case-Control Studies; D053818:Chymases / Q000032:analysis; D004717:Endometrium / Q000276:immunology* / Q000473:pathology; D005260:Female; D051858:Forkhead Transcription Factors / Q000032:analysis; D006784:Hospitals, Teaching; D006801:Humans; D007150:Immunohistochemistry; D008407:Mast Cells / Q000276:immunology; D008875:Middle Aged; D009517:New South Wales; D011127:Polyps / Q000276:immunology* / Q000473:pathology; D011446:Prospective Studies; D019009:Proto-Oncogene Proteins c-kit / Q000032:analysis; D050378:T-Lymphocytes, Regulatory / Q000276:immunology; D053802:Tryptases / Q000032:analysis; D014591:Uterine Diseases / Q000276:immunology* / Q000473:pathology
D015415:Biomarkers; C418974:FOXP3 protein, human; D051858:Forkhead Transcription Factors; D019009:Proto-Oncogene Proteins c-kit; D053818:Chymases; D053802:Tryptases
Abnormal uterine bleeding; Foxp3; endometrial polyp; endometrium; infertility; mast cell; regulatory T cell