• Yorito Yamamoto, Nagamasa Maeda, Chiaki Izumiya, Tomoaki Kusume, Hiroyoshi Oguri, Masaaki Kawashima, Kazutoshi Hayashi, Aki Nomura, Chika Yamashita, and Takao Fukaya.
• Department of Obstetrics and Gynecology, Kochi Medical School, Kohasu, Oko, Nankoku, Kochi, Japan. yoritoy@med.kochi-u.ac.jp
• Fertil. Steril. 2008 Jan 1;89(1):52-9.

ObjectiveTo investigate the macrophage response in endometriosis by determining the expression and localization of human leukocyte antigen (HLA)-ABC and HLA-DR by the peritoneal fluid (PF) macrophages and PF concentrations of interferon (IFN)-gamma that regulate HLA expression.DesignCase-control study.SettingUniversity hospital.Patient(S)64 Japanese endometriosis patients, and 65 women with other laparoscopic diagnoses.Intervention(S)Venipuncture and laparoscopic peritoneal fluid collection.Main Outcome Measure(S)Expression and localization of HLA-ABC and HLA-DR in PF macrophages were determined by flow cytometry and confocal microscopy. The concentration of IFN-gamma in PF was determined by enzyme-linked immunosorbent assay.Result(S)In women with endometriosis, expression of HLA-ABC and HLA-DR by PF macrophages, and the IFN-gamma concentrations in PF were statistically significantly lower than in controls. Women with endometriosis showed a statistically significant positive correlation between HLA expression and IFN-gamma concentration. By confocal microscopy, HLA-ABC was distributed homogenously on the macrophage surface whereas HLA-DR expression on these cells corresponded to the lipid raft.Conclusion(S)In women with endometriosis, low HLA expression and particularly reduced HLA-DR in the lipid raft may be influenced by low IFN-gamma and may compromise antigen presentation, limiting the immune response to peritoneal cavity antigens such as implanted or metaplastic endometrial tissue.

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