PDF(Pubmed)
Abstract：
Endometriosis is a chronic disease affecting 6-10% of women of reproductive age. It is an important cause of infertility and chronic pelvic pain with poorly understood aetiology. CD8+ T (CD8 T) cells were shown to be linked to infertility and chronic pain and play a significant role in lesion clearance in other pathologies, yet their function in endometriosis is unknown. We systematically evaluated the literature on the CD8 T in peripheral blood and endometriosis-associated tissues to determine the current understanding of their pathophysiological and clinical relevance in the disease and associated conditions (e.g. infertility and pelvic pain).
Four databases were searched (MEDLINE, EMBASE, Web of Science, CINAHL), from database inception until September 2022, for papers written in the English language with database-specific relevant terms/free-text terms from two categories: CD8 T cells and endometriosis. We included peer-reviewed papers investigating CD8 T cells in peripheral blood and endometriosis-associated tissues of patients with surgically confirmed endometriosis between menarche and menopause, and animal models with oestrous cycles. Studies enrolling participants with other gynaecological pathologies (except uterine fibroids and tubal factor infertility used as controls), cancer, immune diseases, or taking immune or hormonal therapy were excluded.
28 published case-control studies and gene set analyses investigating CD8 T cells in endometriosis were included. Data consistently indicate that CD8 T cells are enriched in endometriotic lesions in comparison to eutopic endometrium, with no differences in peripheral blood CD8 T populations between patients and healthy controls. Evidence on CD8 T cells in peritoneal fluid and eutopic endometrium is conflicting. CD8 T cell cytotoxicity was increased in the menstrual effluent of patients, and genomic analyses have shown a clear trend of enriched CD8 T effector memory cells in the eutopic endometrium of patients.
Literature on CD8 T cells in endometriosis-associated tissues is inconsistent. Increased CD8 T levels are found in endometriotic lesions, however, their activation potential is understudied in all relevant tissues. Future research should focus on identifying clinically relevant phenotypes to support the development of non-invasive diagnostic and treatment strategies.
PROSPERO identifier CRD42021233304.
Four databases were searched (MEDLINE, EMBASE, Web of Science, CINAHL), from database inception until September 2022, for papers written in the English language with database-specific relevant terms/free-text terms from two categories: CD8 T cells and endometriosis. We included peer-reviewed papers investigating CD8 T cells in peripheral blood and endometriosis-associated tissues of patients with surgically confirmed endometriosis between menarche and menopause, and animal models with oestrous cycles. Studies enrolling participants with other gynaecological pathologies (except uterine fibroids and tubal factor infertility used as controls), cancer, immune diseases, or taking immune or hormonal therapy were excluded.
28 published case-control studies and gene set analyses investigating CD8 T cells in endometriosis were included. Data consistently indicate that CD8 T cells are enriched in endometriotic lesions in comparison to eutopic endometrium, with no differences in peripheral blood CD8 T populations between patients and healthy controls. Evidence on CD8 T cells in peritoneal fluid and eutopic endometrium is conflicting. CD8 T cell cytotoxicity was increased in the menstrual effluent of patients, and genomic analyses have shown a clear trend of enriched CD8 T effector memory cells in the eutopic endometrium of patients.
Literature on CD8 T cells in endometriosis-associated tissues is inconsistent. Increased CD8 T levels are found in endometriotic lesions, however, their activation potential is understudied in all relevant tissues. Future research should focus on identifying clinically relevant phenotypes to support the development of non-invasive diagnostic and treatment strategies.
PROSPERO identifier CRD42021233304.
摘要：
子宫内膜异位症是一种慢性疾病，影响6-10％的育龄妇女。它是不孕和慢性盆腔疼痛的重要原因，病因知之甚少。CD8+T（CD8T）细胞被证明与不孕症和慢性疼痛有关，并在其他病变的病变清除中起重要作用。然而它们在子宫内膜异位症中的作用尚不清楚。我们系统地评估了外周血和子宫内膜异位症相关组织中CD8T的文献，以确定当前对其在疾病和相关疾病（例如不孕和盆腔疼痛）中的病理生理和临床相关性的理解。
搜索了四个数据库(MEDLINE，EMBASE,WebofScience,CINAHL)，从数据库开始到2022年9月，对于以英语撰写的论文，使用数据库特定的相关术语/自由文本术语分为两类：CD8T细胞和子宫内膜异位症。我们纳入了同行评审的论文，研究了初潮和更年期之间经手术证实的子宫内膜异位症患者外周血和子宫内膜异位症相关组织中的CD8T细胞。和有发情周期的动物模型。研究招募其他妇科疾病的参与者（除了子宫肌瘤和输卵管因素不孕症用作对照），癌症,免疫性疾病，或服用免疫或激素治疗被排除。
包括28个已发表的病例对照研究和研究子宫内膜异位症中CD8T细胞的基因集分析。数据一致表明，与在位子宫内膜相比，子宫内膜异位病变中CD8T细胞富集，患者和健康对照组之间的外周血CD8T人群没有差异。关于腹膜液中CD8T细胞和在位子宫内膜的证据是矛盾的。CD8T细胞的细胞毒性在患者的月经流出物中增加，和基因组分析显示，患者在位子宫内膜中CD8T效应记忆细胞富集的趋势明显。
关于子宫内膜异位症相关组织中CD8T细胞的文献不一致。在子宫内膜异位病变中发现CD8T水平升高，然而,它们的激活潜力在所有相关组织中都没有得到充分研究。未来的研究应该集中在确定临床相关的表型，以支持非侵入性诊断和治疗策略的发展。
PROSPERO标识符CRD42021233304。
搜索了四个数据库(MEDLINE，EMBASE,WebofScience,CINAHL)，从数据库开始到2022年9月，对于以英语撰写的论文，使用数据库特定的相关术语/自由文本术语分为两类：CD8T细胞和子宫内膜异位症。我们纳入了同行评审的论文，研究了初潮和更年期之间经手术证实的子宫内膜异位症患者外周血和子宫内膜异位症相关组织中的CD8T细胞。和有发情周期的动物模型。研究招募其他妇科疾病的参与者（除了子宫肌瘤和输卵管因素不孕症用作对照），癌症,免疫性疾病，或服用免疫或激素治疗被排除。
包括28个已发表的病例对照研究和研究子宫内膜异位症中CD8T细胞的基因集分析。数据一致表明，与在位子宫内膜相比，子宫内膜异位病变中CD8T细胞富集，患者和健康对照组之间的外周血CD8T人群没有差异。关于腹膜液中CD8T细胞和在位子宫内膜的证据是矛盾的。CD8T细胞的细胞毒性在患者的月经流出物中增加，和基因组分析显示，患者在位子宫内膜中CD8T效应记忆细胞富集的趋势明显。
关于子宫内膜异位症相关组织中CD8T细胞的文献不一致。在子宫内膜异位病变中发现CD8T水平升高，然而,它们的激活潜力在所有相关组织中都没有得到充分研究。未来的研究应该集中在确定临床相关的表型，以支持非侵入性诊断和治疗策略的发展。
PROSPERO标识符CRD42021233304。
