PECULIARITIES OF IMMUNE REACTIVITY OF ENDOMETRIUM WITH NON-ATYPICAL HYPERPLASIA IN PATIENTS WITH INFERTILITY AND OBESITY
DOI:
https://doi.org/10.11603/24116-4944.2020.2.11849Keywords:
obesity, infertility, non-atypical endometrial hyperplasia, natural killer cells, immunohistochemistry, CD56 , CD16Abstract
The aim of the study – to learn the features of the expression of NK cell subpopulations in the endometrium with non-atypical hyperplasia in patients with infertility and obesity.
Materials and Methods. The study included 84 infertile women with non-atypical endometrial hyperplasia (NAEH), including 44 with normal body weight and 40 with obesity, and 30 relatively healthy women in the control group. Endometrial samples were taken on the 22nd day of the menstrual cycle during the proposed implantation window in women with NAEH – with hysteroscopy, and in women of the control group – with pipel-biopsy. Immunohistochemical determination of CD16+- and CD56+ NK cells in the endometrium was carried out by the avidin-streptavidin-peroxidase method using the corresponding monoclonal antibodies.
Results and Discussion. In infertile women with NAEH, there was an excessive activation of immune reactivity in the endometrium with increased infiltration of its CD56+ and cytotoxic CD16+ NK cells: the expression of CD56 + was 8.14 times higher than the same control parameters ((56.91±2.43) versus (7.18±0.41) ‰, p<0.01), СD16+ – 48.04 times ((41.31±1.84) versus (0.88±0.15) ‰,
p<0.01). At the same time, the content of CD56 + NK cells in the endometrium of women with NAEH and obesity was 1.28 times lower than that in patients with normal body weight ((49.61±3.19) versus (63.55±3.34) ‰, p<0.01); CD16 + content – 1.32 times ((35.32±3.14) versus (46.75±1.71) ‰, p<0.01).
Conclusions. Obesity in infertile women with NHE due to systemic chronic inflammation leads to a decrease in the number and cytotoxicity of NK cells in the endometrium during the expected window of implantation compared to a similar pathology in persons with normal body weight, which may be a factor in the progression of the corresponding neoplastic changes.
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