RESUMEN
BACKGROUND: Researchers have found that macrophages are the predominant cells in the peritoneal fluid (PF) of endometriosis patients. CSF-1 has been found to accumulate in the lesions and PF of endometriosis patients, and CSF-1 induces THP-1-derived macrophages to polarize toward a CD169+ DC-SIGN+ phenotype. Does the cytokine CSF-1 induce monocytes to differentiate into macrophages with a DC-SIGN+ phenotype in endometriosis? METHODS: The level of CSF-1 in the endometrium of control subjects, and the eutopic, and ectopic endometrium of endometriosis patients was evaluated by real-time polymerase chain reaction (qRT-PCR) and was determined by enzyme-linked immunosorbent assay (ELISA) in the PF of control and endometriosis patients. CSF-1 expression was examined with a MILLIPLEX MAP Mouse Cytokine/Chemokine Magnetic Bead Panel. DC-SIGN+ macrophages were detected by immunohistochemical staining of tissues and flow cytometric analysis of the PF of control subjects (N = 25) and endometriosis (N = 35) patients. The phenotypes and biological activities of CSF-1 -induced macrophages were compared in an in vitro coculture system with peripheral blood lymphocytes from control subjects. RESULTS: In this study, we found that the proportion of DC-SIGN+ CD169+ macrophages was higher in the abdominal immune microenvironment of endometriosis patients. CSF-1 was primarily secreted from ectopic lesions and peritoneum in mice with endometriosis. In addition, CSF-1 induced the polarization of macrophages toward a DC-SIGN+ CD169+ phenotype; this effect was abolished by the addition of an anti-CSF-1R antibody. CSF-1 induced the generation of DC-SIGN+ macrophages, leading to a depressed status of peripheral blood lymphocytes, including a high percentage of Treg cells and a low percentage of CD8+ T cells. Similarly, blockade with the anti-CSF-1R antibody abrogated this biological effect. CONCLUSIONS: This is the first study on the role of DC-SIGN+ macrophages in the immune microenvironment of endometriosis. Further study of the mechanism and biological activities of CSF-1-induced DC-SIGN+ macrophages will enhance our understanding of the physiology of endometriosis.
Asunto(s)
Líquido Ascítico/metabolismo , Moléculas de Adhesión Celular/metabolismo , Endometriosis/metabolismo , Lectinas Tipo C/metabolismo , Factor Estimulante de Colonias de Macrófagos/metabolismo , Macrófagos/metabolismo , Enfermedades del Ovario/metabolismo , Receptores de Superficie Celular/metabolismo , Adolescente , Adulto , Animales , Técnicas de Cocultivo , Endometriosis/genética , Femenino , Expresión Génica , Humanos , Leucocitos Mononucleares/citología , Leucocitos Mononucleares/metabolismo , Factor Estimulante de Colonias de Macrófagos/genética , Macrófagos/citología , Ratones , Ratones Endogámicos C57BL , Persona de Mediana Edad , Enfermedades del Ovario/genética , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , Lectina 1 Similar a Ig de Unión al Ácido Siálico/metabolismo , Células THP-1 , Adulto JovenRESUMEN
The objective of this paper was to review the diagnosis and treatment of cervical diseases. Often, due to improper judgment of interventional indications for cervical lesions, overtreatment to various degrees takes place, influencing patients' health and lives. This review analyzes the expression, causes and negative aspects of overtreatment of cervical lesions, and discusses the available therapeutic methods for cervical lesions, to remind gynecologists to master the interventional indications for proper treatment and avoid overtreatment, so as to achieve normalization and individualization in treating gynecologic diseases.