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Altered Monocyte and Lymphocyte Phenotypes Associated with Pathogenesis and Clinical Efficacy of Progestogen Therapy for Peritoneal Endometriosis in Adolescents.

Elena P KhashchenkoLiubov Valentinovna KrechetovaPolina A VishnyakovaTimur Kh FatkhudinovEugeniya V InviyaevaValentina V VtorushinaElena A GantsovaViktoriia V KiselevaAnastasiya S PoltavetsAndrey V ElchaninovElena V UvarovaVladimir D ChupryninGennady T Sukhikh
Published in: Cells (2024)
Background : Immunological imbalances characteristic of endometriosis may develop as early as the primary manifestations of the disease in adolescence. Objective : To evaluate subpopulation dynamics of monocytes and lymphocytes in peripheral blood and peritoneal fluid of adolescents with peritoneal endometriosis at diagnosis and after 1-year progestogen therapy. Methods : This study included 70 girls, 13-17 years old, diagnosed laparoscopically with peritoneal endometriosis ( n = 50, main group) or paramesonephric cysts ( n = 20, comparison group). Phenotypes of monocytes and lymphocytes of the blood and macrophages of the peritoneal fluid were analyzed by flow cytometry at diagnosis and during progestogen therapy. Results : Differential blood counts of CD16 + ( p < 0.001) and CD86 + ( p = 0.017) monocytes were identified as independent risk factors for peritoneal endometriosis in adolescents. During the treatment, cytotoxic lymphocytes CD56dimCD16bright ( p = 0.049) and CD206+ monocytes ( p < 0.001) significantly increased while CD163+ monocytes decreased in number ( p = 0.017). The CD56dimCD16bright blood counts before ( p < 0.001) and during progestogen therapy ( p = 0.006), as well as CD206 + blood counts during the treatment ( p = 0.038), were associated with the efficacy of pain relief after 1-year progestogen therapy. Conclusions : Adolescents with peritoneal endometriosis have altered counts of pro- and anti-inflammatory monocytes and lymphocytes both before and after 1-year progestogen therapy, correlating with treatment efficacy and justifying long-term hormonal therapy.
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