Endometriosis is a disease in which endometrial glands and stroma implant and grow in areas outside the uterus . The most common place to find implants is in the peritoneal cavity, but they can be found in any other place.
Introduction:
Endometriosis is a disease in which endometrial glands and stroma implant and grow in areas outside the uterus . The most common place to find implants is in the peritoneal cavity, but they can be found in any other place. The location and inflammatory response to these lesions are believed to play key role in symptoms and signs associated with endometriosis.
Main theories that explain the etiology of endometriosis: 1) Sampson's theory of transplantation and implantation, through their fallopian tubes into the peritoneum during menstruation (Sampson JA ,1927), 2) Meyer's theory, suggests that metaplasia of the coelomic epithelium is the origin of endometriosis (Meyer R , 1919), and 3) Halban's theory; suggests that distant lesions are established by the hematogenous or lymphogenous spread of active endometrial cells.
Peritoneum and peritoneal fluids:
Is the most extensive serous membrane in the human body, and consists of two layers
Peritoneal fluids arises from plasma and ovarian oxidates, with average volume of 5-20 ml. The peritoneal fluid (PF) is a dynamic environment that links the reproductive and immune systems. It appears likely that endometriotic tissue is influenced by this environment and in turn, the PF is altered by the presence of endometriosis. The result is a cellular mixture rich in cells that can assist the growth and maintenance of endometrial implants as well as inhibition of fertility (Vinatier D,1996).
Role of peritoneal fluid’s cells in endometriosis:
Many cells present in the peritoneal fluids and appear to be play role in endometriosis:
Conclusion:
All available data suggest that peritoneal fluid components changes may play an essential role in the interruption of the whole natural processes of ovulation, fertilization and implantation, more investigation must be done to clarify the role of each of these pathological findings and ways of their elimination.
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References:
1. Sampson JA. Peritoneal endometriosis due to the menstrual dissemination of endometrial tissue into the peritoneal cavity. Am J Obstet Gynecol 1927;14:422-69
2. Meyer R. Uber den staude der frage der adenomyosites adenomyoma in allgemeinen und adenomyometritis sarcomastosa. Zentralb Gynakol 1919;36:745.
3. Weinberg JB, AF Haney, FJ Xu and S Ramakrishnan. Peritoneal fluid and plasma levels of human macrophage colony- stimulating factor in relation to peritoneal fluid macrophage content Department of Medicine and Obstetrics, VA Medical Center, Durham, NCVolume 78, Issue 2, pp. 513-516, 07/15/1991
4. H. Oku, Y. Tsuji, S.-I. Kashiwamura, S. Adachi, A. Kubota, H. Okamura and K. Koyama. Role of IL-18 in pathogenesis of endometriosis. Human Reproduction, Vol. 19, No. 3, 709-714, March 2004.
5. Oosterlynck DJ, C Meuleman, M Waer, PR Koninckx, and M Vandeputte . Immunosuppressive activity of peritoneal fluid in women with endometriosis Obstetrics & Gynecology 1993;82:206-212 .
6. Suzumori, Nobuhiro; Sugiura-Ogasawara, Mayumi; Katano, Kinue; Suzumori, Kaoru Women With Endometriosis Have Increased Levels of Placental Growth Factor in the Peritoneal Fluid Compared With Women With Cystadenomas. Obstetrical & Gynecological Survey. 59(6):438-439, June 2004.
7. Vinatier D, Dufour P, Oosterlynck D. Immunological aspects of endometriosis. Hum Reprod Update 1996; 5:371-84.
8. Leiva M, Hasty LA, Pfeifer S, Mastroianni L, Lytle RC: Increased chemotactic activity of peritoneal fluid in patients with endometriosis. Am J Obstet Gynecol 168:593, 1992.
9. Muscato JJ, Harvey AF, Weinberg JB: Sperm phagocytosis by human peritoneal macroplagues: A possible cause for infertility in endometriosis. Am J Obstet Gynecol 144: 503, 1982.
10. Drake TS, O'Brien WF, Ramwell PW: Peritoneal fluid thromboxane B2 and 6 - ket - Prostaglandin F1a in endometriosis. Am J Obstet Gynecol 140:401, 1981.
11. Rong R, Ramachandran S, Santanam N, Murphy AA, Parthasarathy S. Induction of monocyte chemotactic protein-1 in peritoneal mesothelial and endometrial cells by oxidized low-density lipoprotein and peritoneal fluid from women with endometriosis. Fertil Steril. 2002 Oct;78(4):843-8.
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