Endometriosis Patients Show an Increased M2 Response in the Peritoneal CD14 +low /CD68 +low Macrophage Subpopulation Cou
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ORIGINAL ARTICLE
Endometriosis Patients Show an Increased M2 Response in the Peritoneal CD14+low/CD68+low Macrophage Subpopulation Coupled with an Increase in the T-helper 2 and T-regulatory Cells Quanah J. Hudson 1 & Kazem Ashjaei 1 & Alexandra Perricos 1 & Lorenz Kuessel 1 & Heinrich Husslein 1 & Rene Wenzl 1 & Iveta Yotova 1 Received: 22 January 2020 / Accepted: 6 May 2020 # The Author(s) 2020
Abstract Endometriosis is a chronic inflammatory disease associated with an impaired immune response at the site of lesion implantation. The ability of macrophages to respond to changes in their environment is critical for an effective immune response. However, the existing knowledge of the peritoneal immune cell populations, their activation state and contribution to the immunological changes that occur in endometriosis are still controversial and inconclusive. In this study, we have examined the relative abundance of peritoneal macrophage subtypes, in women with (n = 21) versus without (n = 18) endometriosis and diseaseassociated changes in the adaptive T cell response. Using flow cytometry, we showed that peritoneal fluid monocyte/ macrophages are composed of two populations of cells that exhibit major differences in the levels of the CD14 and CD68 markers, which we classified as the CD14+low/CD68+low and CD14+high/CD68+high subpopulations. Moreover, endometriosisassociated changes in the macrophage subtypes occurred only in the CD14+low/CD68+low subpopulation. In this subpopulation, we found an increased macrophage type 2 response that was coupled with an increase in peritoneal T-helper 2 and T-regulatory cell populations in women with endometriosis, compared with controls. In summary, this study resolves conflicting data in the literature regarding changes in the peritoneal immune cell population in endometriosis and identifies CD14+low/CD68+low macrophages as the subpopulation that changes in response to the disease. Keywords Peritoneal immune microenvironment . Macrophage subtypes . T-regulatory cell . T-helper cell . Endometriosis . CD14 . CD68 . M1 . M2
Quanah J. Hudson and Kazem Ashjaei are joint first authors. Electronic supplementary material The online version of this article (https://doi.org/10.1007/s43032-020-00211-9) contains supplementary material, which is available to authorized users. * Iveta Yotova [email protected]
Lorenz Kuessel [email protected]
Quanah J. Hudson [email protected]
Heinrich Husslein [email protected]
Kazem Ashjaei [email protected]
Rene Wenzl [email protected]
Alexandra Perricos [email protected]
1
Department of Obstetrics and Gynecology, Medical University of Vienna, Waehringer Guertel 18-20, A-1090 Vienna, Austria
Reprod. Sci.
Introduction Endometriosis is a common and often debilitating disease that affects 6–10% of women of reproductive age with prevalence rising to 35–50% in women with pelvic pain and infertility [1, 2]. The disease is characterized by the growth of endometr
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