The body makes an aggressive response to early endometriosis. Leukocyte concentrations in peritoneal fluid are significantly elevated in early disease.

As the disease progresses to more severe stages, the levels of macrophages and T-helper WBCs responsible for mounting an immune response are depressed.

Natural killer cell (NK cells, CD56+ cells) cytotoxicity is an important component of the body's natural immunosurveillance system. Higher levels of estrogen and more advanced stages of disease have been associated with a decreased NK cell function.

Natural killer cell (NK cells, CD56+ cells) cytotoxicity is an important component of the body's natural immunosurveillance system. Higher levels of estrogen and more advanced stages of disease have been associated with a decreased NK cell function.

The use of a GnRH agonist such as Lupron or Zoladex may work to augment the NK cell activity as well as improving macrophage cytoxicity.

For more info:

Hill JA, Faris HMP Schiff I, et al. Characterization of leukocyte subpopulations in the peritoneal fluid of women with endometriosis. Fertil Steril. 1988;50 216-222.

Garzetti GG, Ciavattini A, Provinciali M, et al. Natural killer cell activity in endometriosis: correlation between serum estradiol levels and cytotoxicity. Obstet . Gynecol. 1993;81:665-668.

Braun DP, Gebel H, Rotman C, et al. The development of cytotoxicity in peritoneal macrophages from women with endometriosis. Fertil Steril. 1992;57:1203-1210.