Endometriosis in reproductive immunology.

Abstract

Endometriosis is suggested to represent an autoimmune disorder, but what is the prevalence of autoantibodies to antigens relevant to reproduction? The humoral immune response to the women with endometriosis (stage I-II: 261 women; stage III-IV: 62 women) in serum and in peritoneal fluid was investigated compared with 101 healthy women. Enzyme-linked immunosorbent assay (ELISA) was used in all the women for the detection of seven antiphospholipid antibodies [antiphospholipid antibodies (aPLs) against cardiolipin, L-phosphatidyl (ph)-serine, ph-glycerol, ph-inositol, ph-ethanolamine, phosphatidic (ph)-acid and against beta2-glycoprotein I] of class IgG, IgA, and IgM. A passive haemmagglutination method and ELISA (BioGen) was used for assessment of antizona pellucida antibodies (aZP), tray agglutination test (TAT) and indirect mixed anti-imunoglobulin reaction test (MAR-test) for the determination of sperm antibody levels. Endometriosis I-II were associated with higher serum and peritoneal fluid levels of aPLs against inositol, cardiolipin, ethanolamine, and beta2-glycoprotein I. Forty percent of patients were positive for aZPA. Patients with lesions of endometriosis stage I-II had more autoantibodies than those with stage III-IV, and may be immunologically more active. This result may be significant for future treatments such as in vitro fertilization and embryo transfer.