International Journal of Reproductive BioMedicine

ISSN: 2476-3772

The latest discoveries in all areas of reproduction and reproductive technology.

 

Evaluation of the natural killer cell subsets and their relationship with serum interferon-gamma and vitamin D levels in women with stages III and IV endometriosis: A case-control study

Published date: Sep 03 2024

Journal Title: International Journal of Reproductive BioMedicine

Issue title: International Journal of Reproductive BioMedicine (IJRM): Volume 22, Issue No. 7

Pages: 593–604

DOI: 10.18502/ijrm.v22i7.16933

Authors:

Samira Najafi Chamgordani

Nafiseh Esmaeil

Maryam Hashemi

Afshin Amari

Maryam Seyedtabib

Mehri Ghafourian - Ghafourian-m@ajums.ac.ir

Abstract:

Background: Natural killer (NK) cells play a critical role in the pathogenesis of endometriosis. Moreover, a normal vitamin D level is remarkably associated with an optimal immune response. So, there may be a probable relationship between these factors and the endometriotic women.

Objective: This study aimed to evaluate the percentage of NK cells and their subsets and their relationship with serum levels of vitamin D and interferon-gamma (IFN-γ) in women with endometriosis.

Materials and Methods: In this case-control study, 29 women with stage III-IV endometriosis and 30 healthy controls were enrolled. The study was conducted in the Immunology Department of Isfahan University of Medical Sciences, Isfahan, Iran between November 2021 and June 2022. The percentage of NK cells and their subsets, including CD56dim CD16+, CD56bright CD16- and CD56bright CD16bright were measured in the peripheral blood samples using flow cytometry. Serum levels of vitamin D and IFN-γ were also measured using the enzyme-linked immunosorbent assay.

Results: The mean percentage of NK cells in women with endometriosis increased significantly compared to the control group (p = 0.03). The percentage of CD56dim CD16+ (p = 0.007) and CD56bright CD16 bright (p = 0.043) increased significantly in women with endometriosis in comparison with the control group, but the percentage of CD56bright CD16- subset was not significantly different. No relationship was observed between NK cells and their subsets with vitamin D and IFN-γ in the studied groups.

Conclusion: The study of NK cell subsets and their related factors can be useful in assessing and treating women suffering from endometriosis. However, more comprehensive studies are required to draw definitive conclusions about these observations.

 

Key words: Endometriosis, NK cells, IFN-gamma, Vitamin D.

References:

1. Horne AW, Missmer SA. Pathophysiology, diagnosis, and management of endometriosis. BMJ 2022; 379: e070750.
2. Fukui A, Mai Ch, Saeki Sh, Yamamoto M, Takeyama R, Kato T, et al. Pelvic endometriosis and natural killer cell immunity. Am J Reprod Immunol 2021; 85: e13342.
3. Weaver J, Chakladar S, Mirchandani K, Liu Z. Surgical and pharmacological treatment patterns in women with endometriosis: A descriptive analysis of insurance claims. J Women's Health 2022; 31: 1003-1011.
4. Hoogstad-van Evert J, Paap R, Nap A, van der Molen R. The promises of natural killer cell therapy in endometriosis. Int J Mol Sci 2022; 23: 5539.
5. Reis JL, Rosa NN, Ângelo-Dias M, Martins C, Borrego LM, Lima J. Natural killer cell receptors and endometriosis: A systematic review. Int J Mol Sci 2022; 24: 331.
6. Almassinokiani F, Emadi S, Khodaverdi S, Salehiniya H. Comparison of serum levels of vitamin D between women with and without endometriosis. J Minim Invasive Surg Sci 2015; 4: e30560.
7. Altieri B, Muscogiuri G, Barrea L, Mathieu C, Vallone CV, Mascitelli L, et al. Does vitamin D play a role in autoimmune endocrine disorders? A proof of concept. Rev Endocr Metab Disord 2017; 18: 335-346.
8. Malutan AM, Drugan T, Ciortea R, Bucuri C, Rada MP, Mihu D. Endometriosis-associated changes in serum levels of interferons and chemokines. Turk J Med Sci 2017; 47: 115-122.
9. Skrobot A, Demkow U, Wachowska M. Immunomodulatory role of vitamin D: A review. Adv Exp Med Biol 2018; 1108: 13-23.
10. The American Fertility Society. Revised american fertility society classification of endometriosis: 1985. Fertil Steril 1985; 43: 351-352.
11. Maeda N, Izumiya C, Yamamoto Y, Oguri H, Kusume T, Fukaya T. Increased killer inhibitory receptor KIR2DL1 expression among natural killer cells in women with pelvic endometriosis. Fertil Steril 2002; 77: 297-302.
12. Walankiewicz M, Grywalska E, Krasowska E, Hymos A, Sobstyl M, Kotarski J. The role of NK and NKT-like cells in endometriosis. Eur J Obstet Gynecol Reprod Biol 2016; 206 (Suppl.): e122.
13. Schmitz T, Hoffmann V, Olliges E, Bobinger A, Popovici R, Nößner E, et al. Reduced frequency of perforin-positive CD8+ T cells in menstrual effluent of endometriosis patients. J Reprod Immunol 2021; 148: 103424.
14. Dias Jr JA, Podgaec S, de Oliveira RM, Marin MLC, Baracat EC, Abrão MS. Patients with endometriosis of the rectosigmoid have a higher percentage of natural killer cells in peripheral blood. J Minim Invasive Gynecol 2012; 19: 317-324.
15. Ścieżyńska A, Komorowski M, Soszyńska M, Malejczyk J. NK cells as potential targets for immunotherapy in endometriosis. J Clin Med 2019; 8: 1468.
16. Ghafourian M, Mousavi-Salehi A, Moramazi F, Ranjbari N. Immunohistochemical evaluation of NKP46 receptor expression and the number of NK cells in the endometrium of patients with endometriosis. Iran J Immunol 2024; 21: 27-36.
17. Quatrini L, Della Chiesa M, Sivori S, Mingari MC, Pende D, Moretta L. Human NK cells, their receptors and function. Europ J Immunol 2021; 51: 1566-1579.
18. Thiruchelvam U, Wingfield M, O'Farrelly C. Natural killer cells: Key players in endometriosis. Am J Reprod Immunol 2015; 74: 291-301.
19. Kang Y-J, Cho HJ, Lee Y, Park A, Kim MJ, Jeung IC, et al. IL-17A and Th17 cells contribute to endometrial cell survival by inhibiting apoptosis and NK cell mediated cytotoxicity of endometrial cells via ERK1/2 pathway. Immune Netw 2023; 23: e14.
20. Nishida M, Nasu K, Ueda T, Fukuda J, Takai N, Miyakawa I. Endometriotic cells are resistant to interferon-γ-induced cell growth inhibition and apoptosis: A possible mechanism involved in the pathogenesis of endometriosis. Mol Hum Reprod 2005; 11: 29-34.
21. Wu M-H, Yang B-Ch, Lee Y-Ch, Wu P-L, Hsu Ch-Ch. The differential expression of intercellular adhesion molecule‐1 (ICAM‐1) and regulation by interferon‐gamma during the pathogenesis of endometriosis. Am J Reprod Immunol 2004; 51: 373-380.
22. Hassa H, Tanir HM, Tekin B, Kirilmaz S, Sahin Mutlu F. Cytokine and immune cell levels in peritoneal fluid and peripheral blood of women with early-and late-staged endometriosis. Arch Gynecol Obstet 2009; 279: 891-895.
23. Podgaec S, Abrao M, Dias Jr J, Rizzo LV, De Oliveira R, Baracat EC. Endometriosis: An inflammatory disease with a Th2 immune response component. Hum Reprod 2007; 22: 1373-1379.
24. Xia T, Zeng K, Peng Q, Wu X, Lei X. Clinical significance of serum Th1/Th2 cytokines in patients with endometriosis. Women Health 2023; 63: 73-82.
25. Saeki S, Fukui A, Mai C, Takeyama R, Yamaya A, Shibahara H. Co-expression of activating and inhibitory receptors on peritoneal fluid NK cells in women with endometriosis. J Reprod Immunol 2023; 155: 103765.
26. Mousavi Salehi A, Ghafourian M, Amari A, Zargar M. Evaluation of NKT cell percentage and function and its relationship with serum IFN-γ and vitamin D levels in women with recurrent spontaneous abortion and recurrent implantation failure. Iran J Immunol 2022; 19: 369-377.
27. Dabrowski FA, Grzechocinska B, Wielgos M. The role of vitamin D in reproductive health- a Trojan horse or the golden fleece? Nutrients 2015; 7: 4139-4153.
28. Ota K, Dambaeva S, Kim MWI, Han AR, Fukui A, Gilman‐Sachs A, et al. 1, 25‐dihydroxy‐vitamin D3 regulates NK‐cell cytotoxicity, cytokine secretion, and degranulation in women with recurrent pregnancy losses. Eur J Immunol 2015; 45: 3188-3199.
29. Matasariu DR, Mandici CE, Ursache A, Bausic AIG, Bujor IE, Cristofor AE, et al. Vitamin D and mitosis evaluation in endometriosis: A step toward discovering the connection? Biomedicines 2023; 11: 2102.
30. Delbandi A-A, Torab M, Abdollahi E, Khodaverdi S, Rokhgireh S, Moradi Z, et al. Vitamin D deficiency as a risk factor for endometriosis in Iranian women. J Reprod Immunol 2021; 143: 103266.

Download
HTML
Cite
Share
statistics

0 Abstract Views

14 PDF Downloads