Differential Expression of Granulysin, MHC Class I-Related Chain A, and Perforin in Serum and Peritoneal Fluid: Immune Dysregulation in Endometriosis-Related Infertility.

INTRODUCTION

Endometriosis is a chronic inflammatory disease characterized by endometrial-like tissue outside the uterus. Molecules linked to natural killer (NK) and cytotoxic T cells, including granulysin (GNLY), MHC class I-related chain A (MICA), and perforin (PRF1) support immune surveillance, though their roles in endometriosis remain unclear. This study investigates the association of these molecules with clinical parameters in infertile women with endometriosis.

METHODS

Eighty-seven infertile women undergoing diagnostic laparoscopy were included: 44 with endometriosis and 43 with benign gynecologic disorders. Serum and peritoneal molecules were measured using ELISA. Statistical analyses compared groups and correlated immune markers with clinical parameters.

RESULTS

Endometriosis patients displayed significantly higher PRF1 levels in serum (p = .038) and peritoneal fluid (p = .002), particularly in late-stage disease. Serum and peritoneal PRF1 levels correlated positively with the rASRM adhesion scores. Elevated serum PRF1 was observed in ovarian endometrioma (p = .021). Peritoneal MICA was higher in late-stage endometriosis (p = .013). Serum MICA was elevated in the follicular phase compared to the luteal phase (p = .008).

CONCLUSION

Elevated PRF1 and MICA levels were associated with endometriosis severity, indicating their potential as biomarkers. Future studies should validate this finding and explore its therapeutic role in endometriosis.