Chemokines Modulate the Activity of Several Cells of the Immune System: Relationship with the Pathogenesis of Endometriosis

Endometriosis is a highly prevalent inflammatory condition associated with impaired immune response in the peritoneal cavity and uterus. Evidence points to an involvement of inflammatory mediators such as chemokines in the pathogenesis of this disease. Chemokines are a large family of structurally homologous cytokines that stimulate leukocyte movement and regulate their migration from blood to tissues, also known as chemotactic cytokines. Several chemokines including interleukin-8, Growth-Related Oncogene (GRO) alpha, RANTES, Macrophage Inflammatory Protein (MIP-1) were described as increased in peritoneal fluid of patients with endometriosis. CCL2 and CCL20 were involved in the activation and migration of inflammatory cells in patients with endometriosis. Moreover, the influences of environmental factors such as dioxin in the development of endometriosis appear to be related to the stimulus that RANTES and thymus-expressed chemokine (TECK) could have on them. Furthermore, the peritoneal fluid of patients with endometriosis seem to have an effect on neutrophils, macrophages and T cells making them to secrete more chemokines, such as CXCL10 and CXCL8. The existences of genetic polymorphisms of chemokines were also studied, and an association between rs2812378 and CCL21 was related to advanced stages of endometriosis. Chemokines also seem to have effect on the association between endometriosis and infertility. An increase of chemokines in peritoneal fluid of patients with endometriosis would have effect on sperm by decreasing its mobility and its concentration. The increase in some inflammatory cytokines and chemokines may be responsible for various pain symptoms of endometriosis and even infertility. Although the pathogenesis underlying the development of endometriosis is unknown, there is substantial evidence that chemokines play innumerous roles in the pathogenesis and development of this disease and infertility associated with it. Additional studies evaluating the role of each chemokine along with clinical trials can contribute to a better understanding of the pathogenesis of this disease, as well as be useful in developing a noninvasive diagnosis and feasible therapeutic in the future.