Year: 2026
Type: article
Study design: Observational Study
Abstract: Endometriomas represent a common and clinically significant form of endometriosis, often accompanied by chronic pelvic pain, infertility, and progressive ovarian dysfunction. Although the pathogenesis remains incompletely understood, accumulating evidence points to innate immune dysregulation as a key contributor to the chronic inflammatory microenvironment surrounding ectopic endometrial tissue. The aim of our study was to investigate the features of innate immune response in women with ovarian endometriomas and signs of ovarian dysfunction by assessing serum levels of sTREM-1, MCP-1, and IP-10. The study included 85 reproductive-age women (22-35 years): 50 patients with ovarian endometriomas (unilateral, n = 32; bilateral, n = 18) and 35 healthy controls without endometriosis. Hormonal profiling (FSH, LH, estradiol, AMH) and serum concentrations of innate immune mediators were measured by ELISA. Data are presented as median and interquartile range. Differences between groups were analyzed using the Mann–Whitney test (p 0.05). Patients with endometriomas showed marked hormonal alterations compared with controls. FSH and LH levels were significantly reduced in both unilateral and bilateral subgroups (p 0.001). AMH concentrations were decreased 1.9-2.4-fold (unilateral) and 3.4-3.7-fold (bilateral) (p 0.001). The estradiol changes exhibited a bidirectional pattern, being elevated in unilateral cases and reduced in bilateral disease (p 0.001). Innate immune mediators demonstrated substantial shifts: MCP-1 levels were significantly elevated, whereas IP-10 and sTREM-1 concentrations were decreased, with more pronounced changes in bilateral endometriomas (p 0.001). Bilateral ovarian endometriomas are associated with more severe ovarian dysfunction and profound restructuring of the innate immune response, characterized by enhanced monocyte/macrophage recruitment and diminished interferon-related and myeloid regulatory pathways. The findings suggest a direct link between disease extent, ovarian reserve depletion, and innate immune imbalance thus supporting inclusion of the MCP- 1/IP-10/sTREM-1 panel into laboratory assessment of patients with endometriomas.
Source: Russian Journal of Immunology
Language: English
Subfield: Reproductive Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: diamond
OpenAlex ID: W7225114161