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JMBS 2018, 3(6): 106–115
https://doi.org/10.26693/jmbs03.06.106
Clinical Medicine

Features of Cellular and Humoral Immunity in Patients with External Genital Endometriosis and on the Background of Hypothyroidism

Lysenko B., Habrate B., Lytvak O.
Abstract

The purpose of the study was to analyze the status of cellular and humoral immunity in patients with external genital endometriosis (EGE) on the background of hypothyroidism (HT). Material and methods. The study included 110 patients with external genital endometriosis on the background of hypothyroidism of the thyroid gland. The general clinical, laboratory and instrumental examinations were conducted on the basis of the DNU "Scientific and Practical Center of Preventive and Clinical Medicine" DUS (Kiev, Ukraine). Results and discussion. The study showed that patients with EGE and associated HT had dysmenorrhea less frequently. Oligomenorrhea and bloodstains that smear after menstruation were significantly more frequent than patients of group 1. The presence of 3 of the above-mentioned complaints was observed in 18% of women in group 1, and in 15% of patients in group 2. 56% of group 1 patients and 60% of group 2 patients had permanent pains in the lower abdomen. Disparine was noted by 28% of women with EGE without thyroid disease and 35% of patients with EGE and associated HT. Studies of recent years have shown that immune status violations play an important role in the pathogenesis of EGE. For the purpose of pathogenetic substantiation of the clinical features of EGE with HT we studied the parameters of cell and humoral immunity in the examined women. Conclusions. When combined with genital endometriosis and hypothyroidism, there are pronounced immune disorders that are manifested in cell suppression - CD3 (7.2%), CD4 (8.1%), CD8 (15.2%), CD16 (on 3.5%) and activation of humoral immunity proved by an increase in CD20 (3.3%), IgA (1.9 times) and IgG (1.2 times). The most informative is the presence of correlation between the levels of thyroid stimulating hormone and the studied immunological parameters: reverse average strength correlation between thyroid stimulating hormone and CD3 (r = -0.59; t = 5.1); reverse mean correlation between thyroid stimulating hormone and CD4 (r = -0.59; t = 4.14); negative mean power correlation between thyroid stimulating hormone and CD8 (r = -0.51; t = 4.98); a direct average strength of the relationship between thyroid stimulating hormone and CD16 (r = +0.69; t = 5.57); direct mean strength correlation (r = +0.61; t = 4.82) between secretion of thyroid stimulating hormone and IgA; a direct average strength of the relationship between the secretion of thyroid stimulating hormone and IgG (r = +0.54; t = 5.81); direct average strength correlation between thyroid stimulating hormone and CD20 secretion (r = +0.43; t = 4.17). In the study of cytokine immunity in women with genital endometriosis and hypothyroidism, TNFα is reduced (1.3 times); IL-6 (1.5 times); IL-8 (1.7 times); increase of IL-1 (in 1.5 times); and IL-10 (1.4 times), as well as autoimmune disorders accompanied by an increase in AFL IgG (1.5-fold); antibodies to the native (double-sided) IgG DNA (1.2 times) and a decrease in AFL IgM (1.5 times), indicating a more pronounced change in the autoimmune processes in women of this group.

Keywords: cellular and humoral immunity, external genital endometriosis, hypothyroidism, thyroid gland, infertility, reproductive age, prophylaxis of relapse of genital endometriosis

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