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首页> 外文期刊>American journal of reproductive immunology : >Endometriosis with infertility: A comprehensive review on the role of immune deregulation and immunomodulation therapy
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Endometriosis with infertility: A comprehensive review on the role of immune deregulation and immunomodulation therapy

机译：子宫内膜异位症与不孕症：对免疫失调和免疫调节疗法作用的全面综述

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Background: Endometriosis is a multifactorial pathology dependent on intrinsic and extrinsic factors, but the immune deregulation seems to play a pivotal role. In en-dometriosis-associated infertility, this could raise the benefit of immunomodulatory strategies to improve the results of ART. In this review, we will describe (1) sera and peritoneal fluid cytokines and immune markers; (2) autoantibodies; and (3) immunomodulatory treatments in endometriosis with infertility. Methods: The literature research was conducted in MEDLINE, Embase, and Cochrane Library with the following keywords: "endometriosis", "unexplained miscarriage", "implantation failure", "recurrent implantation failure ? and ? IVF-ICSI ?, ? biomarkers of autoimmunity", "TNF-α", "TNF-α antagonists", "infliximab", "adalimumab", "etaner-cept", "immunomodulatory treatment", "steroids", "intralipids", "intravenous immuno-globulins", "G-CSF", "pentoxyfylline". Results: Several studies analyzed the levels of pro-inflammatory cytokines in sera and peritoneal fluid of endometriosis-associated infertility, in particular TNF-α. Various autoantibodies have been found in peritoneal fluid and sera of infertile endometriosis women even in the absence of clinically defined autoimmune disease, as antinuclear, anti-SSA, and antiphospholipid autoantibodies. In few uncontrolled studies, steroids and TNF-a antagonists could increase the pregnancy rates in endometriosis-associated infertility, but well-designed trials are lacking. Conclusion: Endometriosis is characterized by increased levels of cytokines and autoantibodies. This suggests the role of inflammation and immune cell deregulation in infertility associated with endometriosis. The strategies of immunomodulation to regulate these immune deregulations are poorly studied, and well-designed studies are necessary.
机译：背景：子宫内膜异位症是一种取决于内在和外在因素的多因素病理学，但免疫失调似乎起着关键作用。在结构性异常相关的不育症中，这可能会增加免疫调节策略的好处，以改善艺术的结果。在这篇综述中，我们将描述（1）血清和腹膜液细胞因子和免疫标记。 （2）自身抗体; （3）子宫内膜异位症的免疫调节治疗与不育症。方法：文献研究是在Medline，Embase和Cochrane库中进行的，其中具有以下关键词：“子宫内膜异位症”，“无法解释的流产”，“植入失败”，“经常植入失败？ “，”，“ TNF-α”，“ TNF-α拮抗剂”，“英夫利昔单抗”，“ Adalimumab”，“ Etaner-cept”，“免疫调节性治疗”，“类固醇”，“内脂蛋白”，“静脉内免疫 - 全球蛋白”，“” G-CSF”，“ pentoxyfylline”。结果：几项研究分析了子宫内膜异位症相关的不育症，特别是TNF-α的血清和腹膜液中促炎细胞因子的水平。即使在没有临床定义的自身免疫性疾病的情况下，在腹膜液和血清中的血清中也发现了各种自身抗体，作为抗核，抗SSA和抗磷脂自身抗体。在少数未受控制的研究中，类固醇和TNF-A拮抗剂可能会增加子宫内膜异位症相关的不育症的妊娠率，但缺乏精心设计的试验。结论：子宫内膜异位症的特征是细胞因子和自身抗体的水平升高。这表明炎症和免疫细胞失调在与子宫内膜异位症相关的不育症中的作用。对调节这些免疫消失的免疫调节策略的研究很少，并且必须进行精心设计的研究。

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