Alterations in Cellular Immunity in Patients With Endometriosis: Systematic Review and Meta-Analysis.
Level 3 - non-randomized controlled study
Systematic review and meta-analysis of non-randomized observational/case-control studies
PubMed 42525504 · doi:10.1111/aji.70296
What was done
A systematic review and meta-analysis was conducted across PubMed, The Cochrane Library, ClinicalTrials.gov, Scopus, Embase, and Google Scholar to evaluate alterations in cellular immunity in patients with endometriosis compared to controls. Twenty-four studies met inclusion criteria.
What was found
Peritoneal fluid IL-6 concentration was significantly higher in endometriosis patients than in controls (MD = 338.00, 95% CI: 85.02 to 590.98, p = 0.009). No statistically significant differences were observed for peripheral blood IL-4 (MD = 1.32, 95% CI: -15.00 to 17.63, p = 0.87), peritoneal fluid HLA-DR+ macrophages (MD = -2.62, 95% CI: -8.98 to 3.73, p = 0.42), peritoneal fluid HLA-ABC+ macrophages (MD = -6.84, 95% CI: -23.94 to 10.26, p = 0.43), peritoneal fluid NK-cell levels (MD = 6.75, 95% CI: -12.42 to 25.91, p = 0.49), or NK-cell levels between ectopic and eutopic endometrium (MD = -9.12, 95% CI: -24.39 to 6.15, p = 0.24).
Why it matters
This review quantifies localized peritoneal elevation of the pro-inflammatory cytokine IL-6 in endometriosis, while highlighting that several other proposed cellular immune markers lack consistent aggregate differences.
Limits
The total number of participants, measurement units, and study heterogeneity are not stated in the abstract. Extremely wide confidence intervals across most non-significant comparisons indicate substantial imprecision and variance among the underlying observational studies.
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