Development of peritoneal endometriosis: Characterisation of immune environmentin peritoneal endometriotic lesions
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- Tez No: 723827
- Danışmanlar: Belirtilmemiş.
- Tez Türü: Yüksek Lisans
- Konular: Kadın Hastalıkları ve Doğum, Obstetrics and Gynecology
- Anahtar Kelimeler: Belirtilmemiş.
- Yıl: 2015
- Dil: İngilizce
- Üniversite: Unıversıty Of Sydney
- Enstitü: Yurtdışı Enstitü
- Ana Bilim Dalı: Belirtilmemiş.
- Bilim Dalı: Belirtilmemiş.
- Sayfa Sayısı: Belirtilmemiş.
Özet
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Özet (Çeviri)
Endometriosis is a common gynaecological condition, defined by the presence of endometrial-like glands and stroma at sites outside the uterine cavity, often causing pain and infertility. There are different kinds of endometriotic lesions, of which peritoneal lesions (superficial lesions on pelvic peritoneal surfaces) are the most common. Peritoneal endometriotic lesions have a range of appearances, which are related to lesion development, starting out as red lesions and progressing to become black and then white scarred. Endometriosis is an inflammatory condition in which the immune system is thought to play a fundamental role in the establishment and progression of disease. Within peritoneal endometriotic lesions there is evidence of increased immune cell recruitment and activation, however immune cell densities vary greatly. Although the role of the immune system in endometriosis is well established, it is still unclear how the lesion immune environment relates to peritoneal endometriotic lesion stages of development. Therefore, the main aim of this research project was to investigate the development of peritoneal endometriotic lesions by characterising their immune environment according to macroscopic appearances. Peritoneal endometriotic lesions were prospectively collected (total n=32; red n=12, black n=13 and white n=7). Immunohistochemical staining was performed to identify DC-Sign+ immature and DC-Lamp+ mature dendritic cells; CD4+ helper, CD8+ cytotoxic and Foxp3+ regulatory T cells; CD20+ B cells and CD68+ macrophages. Immune cell densities in and iv around peritoneal endometriotic lesion samples were quantified with MetaMorph image analysis software. All studied immune cell populations were present both in stroma and surrounding tissue of peritoneal endometriotic lesions. While CD8+ cytotoxic T cells, Foxp3+ regulatory T cells and CD68+ macrophages were significantly increased in density in lesion stroma compared to surrounding tissue; DC-Sign+ immature dendritic cells and CD20+ B cells were significantly increased in density in tissue surrounding peritoneal endometriotic lesions. Additionally, there were a number of correlations observed between the densities of different immune cell populations in both stromal and surrounding tissue, indicating relationships and interactions between cell types. However, the density of immune cell populations in and around peritoneal endometriotic lesions was not correlated with the stage of lesion development (lesion appearances). The recruitment of immune cells to tissue within and around peritoneal endometriotic lesions is likely an attempt to attack the lesion. However, their released products may in fact promote processes such as angiogenesis and fibrosis and thereby promote lesion growth and persistence. Immune-targeted treatment approaches show potential efficacy for endometriosis. This study supports the high variability and complexity of endometriosis. The findings from this thesis have implications for understanding of endometriosis pathogenesis, particularly peritoneal lesion development, and also potentially for development of novel treatment approaches
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