The biological role of Treg cells in ectopic endometrium homeostasis
Pawel Basta1, Krzysztof Koper1,2, Wojciech Kazmierczak3, Michal Wisniewski4, Adrianna Makarewicz4,5, Magdalena Dutsch-Wicherek3, Zbigniew Kojs6, Tadeusz J. Popiela7, Robert Slusarz2,8, Mariusz Dubiel2,9 and Lukasz Wicherek1,2
1Gynecology and Oncology Department of the Lukaszczyk Oncological Center, Bydgoszcz, Poland, 2Chair of Gynecology, Oncology and Gynecological Nursing of the Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland, 3Endoscopy of the Head and Neck Cancer Deptartment, The Lukaszczyk Oncological Center, Bydgoszcz, Poland, 4Outpatient Chemotherapy Department, The Lukaszczyk Oncological Center, Bydgoszcz, Poland, 5Chair and Clinic of Oncology and Brachytherapy of the Ludwik Rydygier Collegium Medicum, Nicolaus Copernicus University, Torun, Poland, 6Center of Oncology, Gynecologic Oncology Department, M. Sklodowska-Curie Memorial Institute, Krakow, Poland, 7Radiology Department of the Jagiellonian University, Krakow, Poland, 8Neurological and Neurosurgical Nursing Department, Collegium Medicum, Nicolaus Copernicus University, Torun, Poland and 9Department of Maternal-Fetal Medicine, Gynecology and Neonatology, Colllegium Medicum Nicolaus Copernicus University, Torun, Poland
Offprint requests to: Professor Lukasz Wicherek, MD, PhD, Gynecology and Oncology Departmen of the Lukaszczyk Oncological Center in Bydgoszcz, Poland. e-mail: mowicher@cyf-kr.edu.pl
Summary. Although retrograde menstruation is observed in up to 90% of women, endometriosis actually develops in only15% of women. There is considerable evidence in the literature that ectopic endometrial cells are able to evade immune surveillance and that the immune response in the microenvironment of ectopic lesions is limited. Endometriosis develops when a deficiency in the local immune response has been generated, and progression of the disease is related to the intensity of this process. Over the last couple of decades it has been well known that T regulatory lymphocytes (Tregs) play a crucial role in controlling a variety of physiological and pathological immune responses. In this review we have focused on the physiological alteration of Treg cell infiltration into the endometrium during the reproductive processes of women. We discuss how a disturbance in Treg cell expansion is involved in generating such pathological processes as miscarriage and ectopic pregnancy development. We hypothesize about the role Treg cells might play in the survival of endometriosis foci in ectopic localization and in the evasion of such lesions from host immune surveillance. Histol Histopathol 29, 1217-1233 (2014)
Key words: Endometriosis, Treg, Immune tolerance
DOI: 10.14670/HH-29.1217