Inflammatory changes of the endometrium in patients with minimal-to-moderate endometriosis

Abstract

Objective: To investigate the endometrium of normal patients for chemotactic activity to neutrophils and macrophages and compare these findings with those of patients with endometriosis.

Study design: Endometrial biopsies from patients with and without endometriosis were analyzed for chemotactic activity throughout the menstrual cycle. Glands and stroma of luteal samples were isolated to determine the source of this activity. Infiltrating cells to the endometrium were identified by immunohistochemistry with the use of the monoclonal antibody OKM1.

Results: Luteal endometrial samples from normal patients had higher chemotactic activity than samples from the proliferative phase; this was true for both cells types studied: macrophages, 84 versus 10 and neutrophils, 74 versus 11. Patients with endometriosis had high chemotactic activity in both proliferative and luteal biopsies: macrophages, 73 +/- 9 versus 78 +/- 1 and neutrophils, 41 +/- 18 versus 63 +/- 26. Stromal cells from luteal biopsies demonstrated a higher chemotactic activity than the epithelial component. Immunohistochemistry staining identified the infiltrating cells as macrophages.

Conclusions: Extracts from endometrium of normal patients contain chemotactic activity for neutrophils and macrophages; this activity is higher in the secretory phase of the cycle. Endometriosis patients had high chemotactic activity throughout the menstrual cycle. Separation of the endometrial tissue into stroma and the glandular epithelium indicated that the stromal cells are the source of this factor.