van den Assem, BSc, A.K. (2020) Immunohistochemical characterization of CD4⁺ and CD8⁺ T lymphocytes in endometriotic lesions. thesis, Medicine.
Full text available on request.Abstract
BACKGROUND AND OBJECTIVE Endometriosis is one of the most common benign gynecological diseases and effects approximately one in ten women in the reproductive age worldwide. The etiology and the development of the disease remains enigmatic. Changes in the local immune profile of endometriotic lesions may lead to a local environment where implantation and cell survival is possible. T lymphocytes and macrophages are the major leukocytes found in endometriosis tissue. Nevertheless, studies focusing on the T lymphocyte subpopulation within the endometriotic lesion are limited. The aim of this study is to investigate immunohistochemistry as a feasible method for CD4⁺ and CD8⁺ lymphocyte assessment in ectopic endometriotic lesions, with the final goal to extend the knowledge of the role of the T lymphocytes in endometriosis. METHODS Sections of formalin-fixed, paraffin-embedded endometriosis tissue obtained from patients with symptomatic endometriosis who underwent laparoscopic endometriosis surgery between 2017 and 2019 in the University Medical Centre Groningen (UMCG) were used. CD4⁺T helper cells and CD8⁺ Cytotoxic T cells were analyzed using immunohistochemistry. The quantification was performed manually at a 400x magnification using the digital pathology image analysis software Qupath. Statistical analyses were performed using the parametric independent T-test and the non-parametric Wilcoxon signed-rank test to determine differences between groups. The correlation of continuous variables was tested with the parametric Pearson correlation coefficient or the non-parametric Spearman’s rho. RESULTS In all the evaluated tissue samples CD4⁺ and CD8⁺ cells were visible. The median number of CD4⁺ leukocytes per mm2 was slightly higher than the median number of CD8⁺ leukocytes (3,73 versus 2,93), therefore there is a minor predominance of CD4⁺ leukocytes with a median CD4⁺:CD8⁺ ratio of 1,08 accordingly. CONLUSION We have established that Cytotoxic T cells and T helper cells are present in endometriotic lesions and that immunohistochemistry is an adequate method to visualize the CD4⁺ and CD8⁺ lymphocytes in endometriotic lesions. We discovered a CD4⁺:CD8⁺ ratio of 1,08. A low CD4⁺:CD8⁺ ratio could indicate an altered immune profile in the microenvironment of the endometriotic lesions.
| Item Type: | Thesis (UNSPECIFIED) |
|---|---|
| Supervisor name: | Cantineau, Dr. A. and de Bruyn, Dr. M. and van der Tuuk, Dr. K. and Prins, Dr. J. |
| Faculty: | Medical Sciences |
| Date Deposited: | 02 Aug 2023 11:17 |
| Last Modified: | 02 Aug 2023 11:17 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/3609 |
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