endometriosis is a debilitating condition that affects 10 percent of women worldwide. The condition can seriously affect a person’s quality of life and often causes a range of symptoms, including chronic pain, fatigue and pain during sex.
Despite the prevalence of endometriosis, most women wait on average 7.5 years for a diagnosis in the UK. Not only does this mean many years without treatment, but it puts them at risk of even greater health problems. Untreated endometriosis can lead to it organ damage (including uterus and intestines) and infertility.
There is currently no cure for endometriosis. This may be because of how complex endometriosis is and affects many different parts of the body — meaning researchers still don’t fully understand all of the causes of the disease.
In recent years, studies have shown that the immune system is also affected by endometriosis. Whether the immune system causes endometriosis or is only affected by it is still unclear. But exploring this link could eventually lead to more targeted treatments for the condition.
inflammation and immunity
To understand how our immune system and endometriosis are related, it is first important to understand an immune system process called inflammation.
Inflammation is a key feature of how our immune system works. When the body responds to a harmful pathogen (such as virus or bacteria), our immune system is triggered. The body then secretes special proteins called cytokines that tell our immune cells what to do.
The symptoms you experience as a result of inflammation depend on the reason these cells were mobilized.
For example, if your inflammation is caused by a cut on your finger, you may find that the area around the cut becomes hot, red, and swollen as the immune system works to fight pathogens and repair the damage. If the inflammation is caused by a virus, you may experience flu-like symptoms — such as: Fever.
In most cases, inflammation is a short-term process. But sometimes the immune system gets it wrong and your body keeps sending out inflammatory cells and cytokines even when there is no threat.
An example of this is autoimmune diseases such as rheumatoid arthritis, in which the body’s immune system attacks again and again, leading to long-term inflammation in the joints.
Inflammation is also a normal feature of the menstrual cycle.
The normal menstrual cycle consists of two phases: the follicular phase (from the first day of your period until ovulation) and the luteal phase (from ovulation until the start of your period). Most inflammation during the menstrual cycle occurs in the uterus, but changes can also occur through the body.
During the follicular phase, estrogen levels circulate in the body. Estrogen stimulates the thickening of the uterine lining in preparation for a fertilized embryo.
But some immune cells have specific receptors that recognize estrogen and cause them to make a Immune reaction. This prepares the body to fight off foreign invaders so that it is healthy for pregnancy should fertilization occur. Therefore, women are less prone to infection during the follicular phase. However, women with autoimmune diseases may experience more symptoms at this stage.
In order not to reject a fertilized egg, the immune system is then suppressed during the luteal phase – which can subsequently increase the risk of infection and alleviate some autoimmune symptoms.
Endometriosis and Immunity
Research has observed several changes in the immune system in people with endometriosis.
One study found that patients with endometriosis had elevated levels of inflammation (specifically, higher levels of cytokines). Research has also shown that people with endometriosis have dysfunctional immune cells — a type of immune cell called natural killer cells.
These play a crucial role in combat viruses and tumors, but research shows them work worse in people with endometriosis. The lining of the uterus in patients with endometriosis also shows up produce excess molecules so-called chemokines, which attract other immune cells and worsen inflammation.
Again, it’s still not certain whether altered immune function causes endometriosis or is just a symptom of the disease.
But a dysfunction of the immune system may explain why there is a suspected link between people with endometriosis and autoimmune diseases such as lupus, rheumatoid arthritis and inflammatory bowel disease.
Elevated levels of inflammation also mean that women with endometriosis are more likely to experience worse symptoms during infections.
For example, research has found that patients with endometriosis become infected COVID-19her Symptoms appear to be worse than people who don’t have the condition.
COVID-19 can too worsening endometriosis symptoms – especially pelvic pain, depressionFatigue and gastrointestinal problems.
A Recent study also found that women with endometriosis are 22 percent more likely to have long-term COVID — and their long-term COVID symptoms may last longer.
While it’s not currently known exactly how the immune system is related to endometriosis (and whether it causes the disease), working to better understand this relationship could hold the key to developing better treatments—or possibly even a cure—for endometriosis.
Research into this disease is ongoing severely underfundedand the time to diagnosis is well in excess of what would be expected of other chronic conditions – such as asthma or diabetes.
It is clear that greater priority must be given to research into endometriosis and its causes in order to contribute to new knowledge and better treatment for the millions of women affected.
April Reesbiochemistry tutor, Swansea University
This article is republished by The conversation under a Creative Commons license. read this original article.
