Endometriosis is a widespread disease and commonly reduces the life quality of those affected. Scientific literature indicates different underlying immunological changes. Frequently examined tissues are peripheral blood, endometrial tissue and peritoneal fluid. Yet, knowledge on immunological differences in menstrual effluent (ME) is scarce. In this study, between January 2018 and August 2019, 12 women with endometriosis (rASRM classification: stages I-IV) and 11 healthy controls were included. ME was collected using menstrual cups and venous blood samples (PB) were taken. Mononuclear cells were obtained from ME (MMC) and PB (PBMC) and analyzed using flow cytometry. Concentrations of cell adhesion molecules (ICAM-I and VCAM-I) and cytokines (IL-6, IL-8 and TNF-α) were measured using ELISA. CD8 + T cells obtained from ME were significantly less often perforin-positive in women with endometriosis compared to healthy controls. A comparison between MMC and PBMC revealed that MMC contained significantly less T cells and more B cells. The CD4/CD8 ratio was significantly higher in MMC, and Tregs were significantly less frequently in MMC. In ME, T cells and NK cells expressed significantly more CD69. NK cells obtained from ME were predominantly CD56^bright/CD16^dim and had a lower frequency of perforin + cells compared to PBMC NK cells. Moreover, ICAM-1 plasma levels were significantly reduced in women with endometriosis compared to healthy controls.

In conclusion, CD8 + T cells obtained from the ME were significantly less perforin-positive in endometriosis patients indicating a reduced cytotoxic potential. MMC are distinctively different from PBMC and, thus, seem to be of endometrial origin.

子宫内膜异位症是一种广泛传播的疾病，通常会降低受影响者的生活质量。科学文献表明不同的潜在免疫变化。经常检查的组织是外周血、子宫内膜组织和腹膜液。然而，关于月经流出物 (ME) 的免疫学差异的知识却很少。在这项研究中，2018 年 1 月至 2019 年 8 月期间，12 名子宫内膜异位症女性（rASRM 分类：I-IV 期）和 11 名健康对照被纳入研究。使用月经杯收集 ME 并采集静脉血样本 (PB)。从 ME (MMC) 和 PB (PBMC) 获得单核细胞并使用流式细胞术进行分析。使用ELISA测量细胞粘附分子（ICAM-1和VCAM-1）和细胞因子（IL-6、IL-8和TNF-α）的浓度。与健康对照相比，从 ME 获得的 CD8 + T 细胞在患有子宫内膜异位症的女性中穿孔素阳性的频率显着降低。MMC 和 PBMC 之间的比较表明，MMC 含有明显较少的 T 细胞和较多的 B 细胞。MMC 中的 CD4/CD8 比率显着较高，而 MMC 中 Treg 的频率显着降低。在 ME 中，T 细胞和 NK 细胞表达明显更多的 CD69。从 ME 获得的 NK 细胞主要是 CD56与 PBMC NK 细胞相比，^明亮/CD16^{暗淡且穿孔素 + 细胞的频率较低。}此外，与健康对照组相比，子宫内膜异位症女性的 ICAM-1 血浆水平显着降低。

总之，从 ME 获得的 CD8 + T 细胞在子宫内膜异位症患者中的穿孔素阳性显着降低，表明细胞毒性潜力降低。MMC 与 PBMC 明显不同，因此似乎起源于子宫内膜。