Increased concentrations of activated pelvic macrophages and lymphocytes and the elevated levels of specific cytokines and growth factors reviewed here support the hypothesis that the immune response is intricately associated with the syndrome of endometriosis. Whether components of the innate and adaptive immune systems play a primary role, a causative role, or merely reflect a passive reaction to the presence of ectopic implants is unknown, as are the precise roles of the soluble peritoneal factors. We propose that a complex network of locally produced cytokines modulate the growth and inflammatory behavior of endometriosis (see Fig. 1), including implant proliferation and invasion, the recruitment of capillaries to the growing lesions, and further chemoattraction of leukocytes to foci of peritoneal inflammation. Those who investigate the development of new treatments for endometriosis should consider these potential targets.
|Number of pages
|Infertility and Reproductive Medicine Clinics of North America
|Published - 2002