MITOGEN-INDUCED PRODUCTION OF POLYCLONAL IGG IS DECREASED IN WOMEN WITH SEVERE ENDOMETRIOSIS

PROBLEM: The etiology and/or pathogenesis of endometriosis may involve aspects of both humoral and cellular immunity. METHOD: In this invest igation, we analyzed the ability of B lymphocytes from distinct patien t groups for production of IgG1, IgG2, and IgG3 following in vitro sti mulation with polyclonal B-cell mitogens (pokeweed mitogen and Staphyl ococcus aureus Cowan strain 1) after in vitro stimulation with polyclo nal B-cell activators. RESULTS: We observed that the in vitro producti on of IgG1, IgG2, and IgG3 was identical among fertile controls (no en dometriosis; N = 22), infertile women without endometriosis (N = 22), infertile women without endometriosis (N = 20) and patietns with stage 1 or 2 endometriosis (N = 31). In contrast, in vitro IgG2 production was significantly reduced among women with stage 3 or 4 endometriosis (N = 11) compared to controls (P < 0. 001). CONCLUSION: Since the numb er of circulating B cells was similar in each patient group studied, t he reduced production of IgG2 in patients with stage 3 or 4 disease wa s not merely due to fewer antibody producing cells in those subjects, and we speculate that the observed decrease in polyclonal IgG2 product ion among these patients is due to a primary defect. In additional stu dies, we observed that polyclonal IgG2 production was normal among sta ge 3 or 4 patients treated with danazol (N = 11), but significantly re duced in patients treated with gonadotropin releasing hormone agonists (N = 8). Although not conclusive, these data suggest that danazol may have the capacity to correct the defective production of polyclonal I gG2 in patients with severe endometriosis.