Antinuclear antibodies and endometriosis

J A Dias, João Dias, R M de Oliveira, R M Oliveira, Maurício Simões Abrão, M S Abrao
International Journal of Gynecology & Obstetrics · 2006 · vol. 93(3) , pp. 262–263 · doi:10.1016/j.ijgo.2006.03.005 · PMID:16712848 · W2136313249
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Abstract

Endometriosis is characterized by the implant, growth and development of endometrial tissue in an extra-uterine location. Approximately 5–15% of women present the disease during the reproductive years [1]. Various immunological alterations could explain the development of endometriosis. Those most studied include: an increase in the number and cytotoxicity of macrophages in the peritoneal liquid [2]; polyclonal increase in the activity of B lymphocytes; abnormalities in the functions and concentrations of B and T lymphocytes [2]; and reduction in number or the activity of the natural killer cell [3]. Furthermore, involvement of the humoral immune response in endometriosis with the production of anti-endometrium antibodies has already been described [2]. Antinuclear antibodies (ANA) are frequent serological findings in patients with autoimmune disease, particularly in systemic lupus erythematosus. This antibody was detected in the serum of 29–47% of the patients with endometriosis [4]. On evaluating the characteristics of endometriosis in ANA-positive and ANA-negative patients, the objectives of this study were to establish whether there were differences in the behavior of endometriosis related to ANA positivity. This aspect has not been considered in the articles published to date. The study was approved by the Committee of Ethics and Research of the University of São Paulo Medical School. All the patients read and signed a term of free and informed consent prior to performing the laparoscopy. For the evaluation of antinuclear antibodies, the Patients’ blood samples were centrifuged and the serum was then tested through indirect immunofluorescence using HEp2 cells as substratum (Immuno-Biological Laboratories, Hamburg, Germany). The patients were considered ANA-positive whenever titers were over 1/80. The ANA was studied in 112 consecutive patients submitted to laparoscopy with histological confirmation of endometriosis that were divided in two groups. The first group of patients was ANA-positive (n = 46) and the second group ANA-negative (n = 66). The inclusion criteria used were histological confirmation of endometriosis, FSH < 10 UI/ml and absence of surgical or hormonal treatment during the previous three months. As shown in Table 1, there were no statistical differences regarding the symptoms, infertility prevalence or staging between the groups and 41.1% of patients with endometriosis are ANA-positive. The conclusion of the study was that the presence of ANA in patients with pelvic endometriosis appears to be an immunological secondary effect and does not represent an aggravating factor in patients with pelvic endometriosis.

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Condition tags

mesh:D004715endometriosisinfertility

MeSH descriptors

Antibodies, Antinuclear Endometriosis Age Distribution Antibodies, Antinuclear Antibodies, Antinuclear Autoimmune Diseases Autoimmune Diseases Endometriosis Endometriosis Female Humans Infertility, Female Infertility, Female Laparoscopy

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