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Human Reproduction Update, Vol.4, No.4 pp.360-367, 1998
© European Society of Human Reproduction and Embryology 1998; all rights reserved

Is adenomyosis an immune disease?

H Ota0,z, S Igarashi1, J Hatazawa0 and T Tanaka0

0 Department of Obstetrics and Gynecology, Akita University School of Medicine, Akita-city, Akita-ken 010-8543, Japan 1 Department of Obstetrics and Gynaecology, Koto General Hospital, Hachirogata, Akita-ken 018-1605, Japan z Corresponding author

Abstract

Adenomyosis is characterized as ectopic endometrial tissues within the myometrium in the uterus. The only difference between adenomyosis and endometriosis is the site of endometriotic tissues: inside or outside of the uterus. It is well known that endometriosis is frequently associated with various autoimmune phenomena. This short review covers various aspects of the immune cascade found in adenomyosis. In adenomyosis, a series of immune responses is activated, including changes in both cellular and humoral immunity, i.e. a strong expression of cell surface antigens or adhesion molecules, an increased number of macrophages or immune cells, and deposition of immunoglobulins and complement components. Furthermore, the disease exhibited high frequency of autoantibodies in peripheral blood. Thus, an immunological 'vicious circle' is formed in the endometrium in adenomyosis. Endometrial cells seem to be under immunological stress, protecting themselves by exposing health shock proteins. It is concluded that the endometrial environment in adenomyosis differs widely from that in normal fertile women. These abnormal immune responses might be involved in poor reproductive performance in adenomyosis.

Key words: adenomyosis/autoantibody/endometriosis/immune disease/uterus


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