Quantitative and qualitative peritoneal immune profiles, T-cell apoptosis and oxidative stress-associated characteristics in women with minimal and mild endometriosis

Objectives To assess immunological variables, T-cell apoptosis and oxidative stress markers in the peripheral blood and peritoneal fluid of women with (WEN) and without (WWE) endometriosis. Design: Observational and transverse case-control study. Setting: National Institute of Perinatology, Mexico City, Mexico. Population: and sample Peripheral blood and peritoneal fluid obtained from 30 WWE and 32 WEN. Methods: Blood was drawn before surgery and peritoneal fluid was collected during surgery but before any surgical procedure had been carried out. Flow cytometry, spectrophotometry, high-performance liquid chromatography and multiplex immunoassay analyses were performed. Main outcome measures: Peripheral and peritoneal lymphocyte subpopulations (CD3⁺, CD4⁺ CD3⁺, CD8⁺ CD3⁺, CD16 ⁺ CD56⁺, human leucocyte antigen-DR⁺ CD3 ⁺ and CD19⁺), intracellular CD4⁺ CD3 ⁺ and CD8⁺ CD3⁺ cytokine synthesis (interleukin-2 [IL-2] and interferon-γ [IFN-γ]), CD3⁺ apoptosis, malondialdehyde and ascorbate concentrations and peritoneal cytokine concentrations. Results: No differences were found in peripheral and peritoneal lymphocyte subsets between the groups. Peritoneal T lymphocytes from WEN produced less IL-2 and IFN-γ than those from WWE. Peritoneal malondialdehyde concentrations were higher and ascorbate concentrations were lower in WEN than in WWE. Higher peritoneal concentrations of pro-inflammatory cytokines (IL-1β, tumour necrosis factor-α and IL-6) and chemokines (IL-10, IL-8, eotaxin, vascular endothelial growth factor, monocyte chemotactic protein-1 and regulated upon activation, normal T-cell expressed, and secreted) and lower concentrations of IFN-γ, IL-1 receptor antagonist and IL-15 were found in WEN. No statistical differences were found in IL-2, IL-4, IL-12 and IL-13 concentrations. Conclusion The alterations observed in WEN were associated with a diminished peritoneal T helper type 1 immune response. Pro-inflammatory, chemotactic, angiogenic and oxidative stress markers were altered in the peritoneal milieu of WEN. These changes appeared to contribute to the peritoneal immune alterations found.