PMID- 36870297
OWN - NLM
STAT- MEDLINE
DCOM- 20230525
LR  - 20230628
IS  - 1872-7603 (Electronic)
IS  - 0165-0378 (Linking)
VI  - 157
DP  - 2023 Jun
TI  - Characterising the immune cell phenotype of ectopic adenomyosis lesions compared 
      with eutopic endometrium: A systematic review.
PG  - 103925
LID - S0165-0378(23)00131-6 [pii]
LID - 10.1016/j.jri.2023.103925 [doi]
AB  - Inflammation is implicated in the symptomatology and the pathogenesis of 
      adenomyosis. Injury at the endo-myometrial interface causes inflammation and may 
      facilitate the invasion of endometrium into the myometrium, forming adenomyosis 
      lesions. Their presence causes local inflammation, resulting in heavy menstrual 
      bleeding, chronic pelvic pain, and subfertility. Immunological differences have 
      been described in the eutopic endometrium from women with adenomyosis compared to 
      healthy endometrium, and differences are also expected in the adenomyotic lesions 
      compared with the correctly sited eutopic endometrium. This systematic review 
      retrieved relevant articles from three databases with additional manual citation 
      chaining from inception to 24th October 2022. Twenty-two eligible studies were 
      selected in accordance with PRISMA guidelines. Risk of bias assessments were 
      performed, and the findings presented thematically. Ectopic endometrial stroma 
      contained an increased density of macrophages compared with eutopic endometrium 
      in adenomyosis. This was associated with an increase in pro-inflammatory 
      cytokines (IL-6, IL-8, ILbeta-1, C-X-C Motif Chemokine Receptor 1(CXCR1), Monocyte 
      Chemoattractant Protein-1 (MCP-1)), and an imbalance of anti-inflammatory 
      cytokines (IL-22, IL-37). Cells in ectopic lesions also contained a higher levels 
      of toll-like receptors and immune-mediated enzymes. However, the studies were 
      heterogeneous, with inconsistent reporting of immune cell density within 
      epithelial or stromal compartments, and inclusion of samples from different 
      menstrual cycle phases in the same group for analysis. A detailed understanding 
      of the immune cell phenotypes present in eutopic and ectopic endometrium in 
      adenomyosis and associated dysregulated inflammatory processes will provide 
      further insight into the pathogenesis, to enable identification of 
      fertility-sparing treatments as an alternative to hysterectomy.
CI  - Copyright (c) 2023 Elsevier B.V. All rights reserved.
FAU - Maclean, Alison
AU  - Maclean A
AD  - Department of Women's and Children's Health, Institute of Life Course and Medical 
      Sciences, University of Liverpool, Liverpool L8 7SS, United Kingdom; Liverpool 
      Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, 
      Liverpool L8 7SS, United Kingdom. Electronic address: amaclean@liverpool.ac.uk.
FAU - Barzilova, Vanya
AU  - Barzilova V
AD  - Department of Women's and Children's Health, Institute of Life Course and Medical 
      Sciences, University of Liverpool, Liverpool L8 7SS, United Kingdom.
FAU - Patel, Simran
AU  - Patel S
AD  - Department of Women's and Children's Health, Institute of Life Course and Medical 
      Sciences, University of Liverpool, Liverpool L8 7SS, United Kingdom.
FAU - Bates, Faith
AU  - Bates F
AD  - Department of Women's and Children's Health, Institute of Life Course and Medical 
      Sciences, University of Liverpool, Liverpool L8 7SS, United Kingdom; School of 
      Life Sciences, Faculty of Health and Life Sciences, University of Liverpool, 
      Liverpool L69 7ZB, United Kingdom.
FAU - Hapangama, Dharani K
AU  - Hapangama DK
AD  - Department of Women's and Children's Health, Institute of Life Course and Medical 
      Sciences, University of Liverpool, Liverpool L8 7SS, United Kingdom; Liverpool 
      Women's Hospital NHS Foundation Trust, Member of Liverpool Health Partners, 
      Liverpool L8 7SS, United Kingdom.
LA  - eng
GR  - MR/V007238/1/MRC_/Medical Research Council/United Kingdom
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
PT  - Systematic Review
DEP - 20230301
PL  - Ireland
TA  - J Reprod Immunol
JT  - Journal of reproductive immunology
JID - 8001906
RN  - 0 (Cytokines)
SB  - IM
MH  - Humans
MH  - Female
MH  - *Adenomyosis/pathology
MH  - Endometrium/pathology
MH  - Cytokines/metabolism
MH  - Inflammation/metabolism
MH  - Phenotype
OTO - NOTNLM
OT  - Adenomyosis
OT  - Ectopic endometrium
OT  - Eutopic endometrium
OT  - Immune cells
OT  - Systematic review
COIS- Conflicts of interests The authors declare that they have no conflicts of 
      interest to declare.
EDAT- 2023/03/05 06:00
MHDA- 2023/05/25 06:42
CRDT- 2023/03/04 18:19
PHST- 2022/12/23 00:00 [received]
PHST- 2023/02/16 00:00 [revised]
PHST- 2023/02/28 00:00 [accepted]
PHST- 2023/05/25 06:42 [medline]
PHST- 2023/03/05 06:00 [pubmed]
PHST- 2023/03/04 18:19 [entrez]
AID - S0165-0378(23)00131-6 [pii]
AID - 10.1016/j.jri.2023.103925 [doi]
PST - ppublish
SO  - J Reprod Immunol. 2023 Jun;157:103925. doi: 10.1016/j.jri.2023.103925. Epub 2023 
      Mar 1.