Objective: To characterise peritoneal macrophage populations in women with suspected endometriosis and assess if they are correlated with severity of pelvic pain symptoms. Design: Flow cytometry analysis of peritoneal fluid samples and clinical data. Setting: University Research Institute. Patients: Clinical questionnaires, surgical data and peritoneal fluid were collected with informed consent from women undergoing diagnostic laparoscopy for suspected endometriosis (n=54). Intervention(s): None Main Outcome Measure(s): Severity of pelvic pain symptoms was assessed by the EHP-30 questionnaire. Immune cells recovered from peritoneal fluid were analysed by flow cytometry. Results: Pain scores (pain domain of EHP30) did not differ according to endometriosis diagnosis, stage of endometriosis or whether or not women were receiving hormone treatment. Analysis of immune cells in peritoneal fluid revealed two populations of peritoneal macrophages: CD14high and CD14low which were not altered by menstrual cycle phase or hormone treatment. CD14high peritoneal macrophages were increased in women with endometriosis compared to those without but were not altered by coincident reproductive health issues such as infertility or heavy menstrual bleeding. Peritoneal macrophage phenotype correlated with pelvic pain symptoms in women with suspected endometriosis. Notably, CD14high peritoneal macrophages negatively correlated with pain scores whereas CD14low peritoneal macrophages were positively correlated. This association was independent of endometriosis diagnosis. Conclusion: Peritoneal macrophage phenotypes correlate with pelvic pain symptoms in women with suspected endometriosis and are altered by presence of disease. These results provide new insight into the association between endometriosis pathophysiology and pelvic pain symptoms.

中文翻译：

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怀疑子宫内膜异位症女性的腹膜巨噬细胞表型与疼痛评分相关

目的：确定可疑子宫内膜异位症妇女腹膜巨噬细胞的数量，并评估它们是否与盆腔疼痛症状的严重程度相关。设计：腹膜液样品的流式细胞术分析和临床数据。单位：大学研究所。患者：在接受诊断性腹腔镜检查的怀疑有子宫内膜异位症的妇女（n = 54）的知情同意下，收集临床调查表，手术数据和腹膜液。干预措施：无主要结果指标：通过EHP-30问卷评估骨盆疼痛症状的严重程度。通过流式细胞术分析从腹膜液中回收的免疫细胞。结果：根据子宫内膜异位症的诊断，子宫内膜异位症的分期或妇女是否接受激素治疗，疼痛评分（EHP30的疼痛域）没有差异。腹膜液中免疫细胞的分析显示了两个腹膜巨噬细胞群：CD14high和CD14low，它们在月经周期阶段或激素治疗后均未改变。与没有子宫内膜异位症的女性相比，患有子宫内膜异位症的女性的CD14高腹膜巨噬细胞增加，但由于生殖健康问题如不孕或月经大量出血而没有改变。怀疑子宫内膜异位症的女性腹膜巨噬细胞表型与骨盆疼痛症状相关。值得注意的是，CD14高腹膜巨噬细胞与疼痛评分呈负相关，而CD14低腹膜巨噬细胞呈正相关。这种关联独立于子宫内膜异位症的诊断。结论：腹膜巨噬细胞表型与可疑子宫内膜异位症妇女的骨盆疼痛症状相关，并因疾病的存在而改变。这些结果为子宫内膜异位症病理生理学与盆腔疼痛症状之间的关联提供了新的见解。