Archives of Gynecology and Obstetrics

, Volume 294, Issue 3, pp 657–664 | Cite as

Characterization of endometriosis-associated immune cell infiltrates (EMaICI)

  • Claudia Scheerer
  • Petia Bauer
  • Vito Chiantera
  • Jalid Sehouli
  • Andreas Kaufmann
  • Sylvia Mechsner
Gynecologic Endocrinology and Reproductive Medicine



To identify and characterize endometriosis-associated immune cell infiltrates (EMaICI). Furthermore, to define occurrence and size of EMaICI in various types of endometriosis.


Immune cells were characterized in samples of 60 premenopausal women with histological proven endometriosis. Therefore, immunohistochemical staining with monoclonal antibodies for CD3, CD4, CD8, CD45RO, CD25, CD56, CD68, and CD20 on sections of paraffin-embedded endometriotic tissue was performed.


EMaICI were observed in all the types of endometriosis, and characterized as T lymphocytes (CD3+), helper T lymphocytes (CD4+), cytotoxic T lymphocytes (CD8+), antigen-experienced T lymphocytes”memory cells” (CD45RO+), macrophages (CD68+), and B lymphocytes (CD20+). The maximum frequency of EMaICI and their distribution per endometriotic lesion (EML) was observed in peritoneal endometriosis (pEM) and in ovarian endometriosis (Ov. EM). In myometrium from adenomyosis (M/AM), EMaICI occurrence was lower and smaller in size in comparison with EMaICI seen in other forms of endometriosis. EMaICI were negative for regulatory T cells (CD25+ high, FoxP3+) and natural killer cells (NK cells, CD56+).


Numerous and brisk EMaICI comprising several types of immune cells in all endometriosis forms suggest acute immunological reactions within the microenvironment of endometriosis lesions.


Endometriosis Immune cell infiltrates Chronic inflammatory disease Immune cell defect 





Cluster of differentiation


Deep infiltrating rectovaginal endometriosis


Endometriosis disease theory




Endometriosis-associated immune cell infiltrates


Endometriotic lesions


Endometrium from patients with peritoneal EM


Endometrium from adenomyosis


Endometrium from uterus myomatosus, used as control


Immune cell infiltrates




Myometrium from adenomyosis


Myometrium from myomatosus uterus, used as control


Natural killer cells


Non-lesional peritoneum, used as control


Non-lesional ovarium, used as control

Ov. EM

Ovarian endometriosis

p EM

Peritoneal endometriosis


Proliferative phase


Secretory phase


Compliance with ethical standards

Conflict of interest

All authors of this work declare that they have no conflict of interest.

Ethical issues

All procedures performed in this study involving human samples were in accordance with the ethical standards of the Charité ethics committee. The study was approved by the IRB of Charité ethics committee (EA) and informed consent was obtained from all patients.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Claudia Scheerer
    • 1
  • Petia Bauer
    • 1
  • Vito Chiantera
    • 1
  • Jalid Sehouli
    • 1
  • Andreas Kaufmann
    • 1
  • Sylvia Mechsner
    • 1
  1. 1.Department of Gynecology, CharitéEndometriosis Research Center CharitéBerlinGermany

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