665 The state of local immune interrelations in patients with adenomyosis

Abstract

ObjectiveThe frequency of adenomyosis reaches 70%. The intrusion of the basal layer of the endometrium into the myometrium is possible in case of a violation of local immunity, which is formed against the background of causative agents of genital infection. The study of immune interrelations in the uterus in patients with adenomyosis will expand the understanding of the pathogenesis. Study design: 159 women with adenomyosis were examined. In the cervical secretion, a quantitative assessment of the levels of cytokines associated with the activity of innate immune defense IL-4,8,10,18, TNF, INF, the concentration of sIgA, IgA, M, G, the concentration of C3, C4 components of complement and lysozyme. In the endometrium, Chlamydia trachomatis, Ureaplasma spp., Mycomlasma genitalium, HSV1,2 / CMV, HPV were determined by PCR. Results: In the presence of genital pathogens in patients with adenomyosis, disorders of innate immunity were revealed, manifested in an increased content of sIgA, IgA, G (p <0.05), which may be a consequence of impaired permeability of the mucous membranes. An increase in the level of pro-inflammatory (IL-8, IL-18, TNF) and a decrease in the level of anti-inflammatory cytokines (IL-4, IL-10), INF (p <0.05) were revealed. The complement system is activated, as evidenced by an increase in the level of C3, C4 (p <0.05). An increase in proinflammatory cytokines at the local level aims to limit inflammatory processes in the endometrium and promoting the development of a T-cell immune response. Conclusions: In patients with adenomyosis, signs of immunopathology are observed, leading to a weakening of immune control, which creates conditions for the development of endometrial heterotopies. Formed against the background of bacterial and viral pathogens, immune disorders can contribute to the invasion of endometrial cells into the adjacent myometrium.