Telocytes in Inflammatory Gynaecologic Diseases and Infertility
Women suffered with inflammatory gynecologic diseases, such as endometriosis (EMs) and acute salpingitis (AS) often complained of sub- or infertility, even in those women without obvious macroscopic anatomical pelvic abnormalities also have unexplained in
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Telocytes in Inflammatory Gynaecologic Diseases and Infertility Xiao-Jun Yang
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Introduction
Infertility is a common disease in women of reproductive age. It can be divided into anatomical and functional disease. Anatomically, oviduct and uterine diseases, such as severe endometriosis, tubal ectopic pregnancy, para-tubal adhesion after pelvic inflammatory diseases, uterine septum, intrauterine adhesion, etc., frequently cause infertility. On the other hand, among the functional reasons, immune-mediated fertility problems and related diseases, such as autoimmune diseases, early stage of endometriosis, pelvic inflammatory disease and salpingitis, were the predominant diseases in the clinic. Generally, the female reproductive tract must maintain a unique immune micro-environment, in order to tolerate the semi-allogeneic sperm and foetus and protect against harmful pathogens [1, 2]. Further researches showed that immunocytes such as monocyte and macrophage, which were important multifunctional players in local peritoneal immune response in endometriosis or pelvic inflammatory disease, and their dysfunction or uncontrolled augmentations in quantity and/or activation might not only change smooth muscle motility, microcirculation and pelvic pain in endometriosis [3] but also lead to immune-mediated fertility problems, such as miscarriage, tubal infertility and tubal ectopic pregnancy [4, 5]. Endometriosis (EMs) is a kind of aseptic inflammatory, ischemic, oestrogendependent disease with many clinical manifestations [6, 7]. It was characterized by the presence of endometrium outside the uterine cavity and affects an estimated 8–10 % of women of reproductive age in industrialized countries [6, 8]. Generally,
X.-J. Yang, PhD Department of Obstetrics and Gynecology, The First Affiliated Hospital of Soochow University, 188 Shizi Road, Suzhou City, Jiangsu Province 215006, People’s Republic of China e-mail: [email protected] © Springer Science+Business Media Singapore 2016 X. Wang, D. Cretoiu (eds.), Telocytes, Advances in Experimental Medicine and Biology, 913, DOI 10.1007/978-981-10-1061-3_18
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massive monocyte/macrophage and lymphocyte aggregation, which overproduce cytotoxic substance, such as inflammatory factors (iNOS, COX-2), oxidative stress (LPO) and estradiol, was the most frequent pelvic micro-environment changes in EMs [7–9]. Then, EMs causes many abnormalities either in local anatomy or reproductive endocrine and immunologic micro-environment disorders, subsequently leading to various clinical symptoms, such as chronic pelvic pain, hypermenorrhoea, dysmenorrhoea and sub- or infertility [8]. Current knowledge regarding EMs-related fertility disorders remains insufficient. Generally, in women with obvious macroscopic anatomical changes of the pelvis, mechanical interference will be adversely affected by oocyte pickup, transport and tubal peristalsis. However, women with absence of macroscopic pelvic alterations also complained of unexplained functional sub- or infertility [8], of w
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