IS ADENOMYOSIS AN IMMUNE DISEASE

Adenomyosis is characterized as ectopic endometrial tissues within the myometrium in the uterus, The only difference between adenomyosis and endometriosis is the site of endometriotic tissues: inside or outside of the uterus, It is well known that endometriosis is frequently asso ciated with various autoimmune phenomena. This short review covers var ious aspects of the immune cascade found in adenomyosis. In adenomyosi s, a series of immune responses is activated, including changes in bot h cellular and humoral immunity, i,e, a strong expression of cell surf ace antigens or adhesion molecules, an increased number of macrophages or immune cells, and deposition of immunoglobulins and complement com ponents. Furthermore, the disease exhibited high frequency of autoanti bodies in peripheral blood. Thus, an immunological 'vicious circle' is formed in the endometrium in adenomyosis, Endometrial cells seem to b e under immunological stress, protecting themselves by exposing heat s hock proteins. It is concluded that the endometrial environment in ade nomyosis differs widely from that in normal fertile women. These abnor mal immune responses might be involved in poor reproductive performanc e in adenomyosis.