Abstract
Study question
To study the expression of CD4, CD8, CD20, CD 138 in the tissue of the pelvic peritoneal adhesions at women of reproductive age.
Summary answer
Immunohistochemical study of pelvic adhesions revealed the CD8-positive cells is directly involved in the formation of the immune response at the late stages of adhesiogenesis.
What is known already
One of the reason identifies the high frequency of adhesion formation is the presence of inflammation in the abdominal cavity with different severity and origin. It is known that Insufficiency of the fibrinolytic system, increased levels of a number of cytokines, including transforming growth factor- β1, and tissue hypoxia induce neoangiogenesis and fibrotization of the fibrin matrix, which leads to the formation of adhesions. Data on expression of CD4, CD8, CD20, CD138/syndecan–1 in the pelvic peritoneal adhesions in connection with their prescription, localization and origin is absent at accessible literature.
Study design, size, duration
Two hundred infertile women (aged 19–49 yrs) with pelvic peritoneal adhesions, who were underwent operative laparoscopy and adhesiolysis.
Participants/materials, setting, methods
The material for this study was the fragments of surgical material (adhesions and their parts) n = 200, taken from the women of reproductive age who suffered with infertility during operative laparoscopy.The morphological and immunohistochemical study of adhesions were carried out by standard techniques using paraffin blocks, reagents of Dako and monoclonal antibodies to CD4 (Clone 4B12 Ready-to-Use),CD8 (Clone C8/144B Ready-to-Use), CD20 (Clone L26 Ready-to-Use),CD138/syndecan–1 (Clone MI15 Ready-to-Use) of Abcam with automatic coloring Dako Cytomation.
Main results and the role of chance
To assess the population composition of these cell infiltrates, as well as individual diffusely located inflammatory cells, an immunohistochemical method with the main lymphocytic markers (CD4, CD8, CD20, CD138) was used. First of all, it is necessary to note the complete absence of CD20-positively colored cells in all observations, which indicates that at the final stage of the formation of adhesions, there is no element of the B-lymphocytic immune response. In an immunohistochemical study with syndecan–1 (CD138) antibodies, we identified a small number of positively colored cells that were located mainly perivascular, as part of mononuclear infiltrates. Quantitative analysis showed that the number of such cells is 0.8±0.2. When studying CD4–positive T-lymphocytes, it was found that they are usually located in the form of band-shaped infiltrates and focal perivascular clusters. The number of CD4-positive cells in the spike tissue is 5.6±0.2. CD8-positive cells were located mainly submesothelial, and in the form of perivascular clusters, the number of such cells was 9.2±0.6.
Limitations, reasons for caution
Age limitation, only women aged 19–49 yrs took part in this study. Exclusion criteria were the following for the groups: acute gynecological diseases, malignant diseases of female genitalia and ovarian tumors.
Wider implications of the findings: The absence of B-cells in the “mature” adhesions’ tissue was found.The number of CD8-positive cells in our study was 1.5 times higher than the number of CD4-positive T-lymphocytes.CD4-positive T-lymphocytes play an important role and their number significantly prevails over the number of CD8-positive T-lymphocytes at the initial stages of adhesiogenesis.
Trial registration number
Case control study
Complex Laparoscopic Myomectomy with Severe Adhesions Performed with Proper Preventive Measures and Power Morcellation Provides a Safe Choice in Certain Infertility Cases