CELL-MEDIATED-IMMUNITY TO HUMAN AND ESCHERICHIA-COLI 60-KDA HEAT-SHOCK-PROTEIN IN WOMEN - ASSOCIATION WITH A HISTORY OF SPONTANEOUS-ABORTION AND ENDOMETRIOSIS

PROBLEM: Heat shock proteins are expressed during early pregnancy and in peritoneal fluids from women with endometriosis. The relationship b etween a cell-mediated immune response to human 60-kDa heat shock prot ein (hsp60), spontaneous abortion, and endometriosis was examined. MET HOD OF STUDY: Peripheral blood mononuclear cells (PBMCs) from 110 fema le partners of infertile couples undergoing in vitro fertilization and 41 fertile control subjects were incubated with human hsp60 or Escher ichia coli hsp60. PBMC proliferation was measured by [H-3]thymidine in corporation, and a stimulation index was calculated. RESULTS: Lymphocy tes from 21.8% of the infertile women, as opposed to 7.3% of the ferti le women, proliferated in response to human hsp60 (P = 0.05). In contr ast, proliferation in response to the E. coli hsp60 was equivalent in both groups. Within the infertile group, the response to human hsp60 w as 40.7% among women with a history of spontaneous abortion and only 1 2% in those with no history of spontaneous abortion (P = 0.003). There was no association between immunity to E. coli hsp60 and spontaneous abortion or between immunity to human hsp60 and therapeutic abortion o r the cause of infertility. Immunity to the E. coli hsp60 was associat ed with endometriosis. CONCLUSIONS: A cell-mediated autoimmune respons e to human hsp60 is associated with a history of spontaneous abortion, whereas immunity to E. coli hsp60 was most prevalent in women with en dometriosis.