Changes in the number and activity of natural killer cells and its clinical association with endometriosis: systematic review and meta-analysis

Getnet Gedefaw Azeze M.Sc. , Ling Wu M.D., Ph.D. , Bekalu Kassie Alemu M.Sc. , Chi Chiu Wang M.D., Ph.D. , Tao Zhang M.D., Ph.D.
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引用次数: 0

Abstract

Objective

To pool all available data from literature and compare the differences in cell percentages and cytotoxicity of peripheral blood, peritoneal fluid, and uterine natural killer (NK) cells (pNK, pfNK, uNK) between individuals with endometriosis and those without. In addition, we examined the differences in NK cells between early and advanced stages of endometriosis.

Evidence review

International databases such as PubMed, Web of Science, Scopus, Google Scholar, and EMBASE through OVID were searched. Meta-analysis was conducted according to the PRISMA (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocol) and PICO (Population, Intervention, Comparison, and Outcome) frame. STATA 17 was used to analyze the data. T2 and I2 Statistics were calculated to check heterogeneity. Meta-analysis was performed to compare the percentage and cytotoxic activity of NK cells between different groups. A random effect model was used to pool all the available data. Subgroup and sensitivity analysis were used to identify the source of heterogeneity.

Results

We included 29 case control and 2 cross-sectional studies across 13 countries that met our inclusion criteria. There was no significant difference in the percentage of pNK cells (mean difference [MD] 1.94, 95% confidence interval [CI] −0.52, 4.39; I2 94.52%; total of 915 women), and pfNK cells (MD 2.12, 95% CI −5.26, 9.5; I2 96.59%; total 397 women) between women with endometriosis and controls. However, the percentage of uNK cells (MD 3.91, 95% CI 1.63, 6.19; I2 0%; a total of 149 women) was significantly higher in women with endometriosis compared with controls. The study also found that the cytotoxic activity of pNK cells (MD −8.01, 95% CI −13, −3.02; I2 40.27%; total of 187 women), pfNK cells (MD −9.94, 95% C: −13.53, −6.34; I2 0%; total 110 women), and uNK cells (MD −12.1, 95% CI −17.95, −6.27; I2 16.75%; total 104 women) were significantly lower in women with endometriosis compared with the control group. Similarly, the pooled mean lytic unit of pNK cell cytotoxicity in women with endometriosis (MD −2.77, 95% CI −3.91, −1.63; I2 0%; total of 74 women) was significantly lower than controls. However, there was no significant difference in the NK cell cytotoxicity between the early and advanced stages of endometriosis.

Conclusion

The consistent reduction of NK cell cytotoxicity across different samples (peripheral blood, peritoneal fluid, and endometrial tissue) may provide insights into the pathogenesis of endometriosis. Establishing standardized references for the cytotoxicity of uNK, pfNK, and pNK cells, as well as the percentage of uNK cells, is a prerequisite to determining their potential values in clinical diagnosis and treatments.

NK细胞数量和活性的变化及其与子宫内膜异位症的临床关联:系统回顾和荟萃分析
目的汇集所有可用的文献数据,比较子宫内膜异位症患者与非子宫内膜异位症患者的外周血、腹腔液和子宫自然杀伤(NK)细胞(pNK、pfNK、uNK)在细胞百分比和细胞毒性方面的差异。此外,我们还研究了早期和晚期子宫内膜异位症患者 NK 细胞的差异。证据综述通过 OVID 检索了 PubMed、Web of Science、Scopus、Google Scholar 和 EMBASE 等国际数据库。根据 PRISMA(系统性综述和元分析首选报告项目)和 PICO(人群、干预、比较和结果)框架进行元分析。使用 STATA 17 分析数据。计算 T2 和 I2 统计量以检查异质性。进行 Meta 分析以比较不同组间 NK 细胞的百分比和细胞毒性活性。采用随机效应模型汇集所有可用数据。结果我们纳入了 13 个国家中符合纳入标准的 29 项病例对照研究和 2 项横断面研究。患有子宫内膜异位症的妇女与对照组之间的 pNK 细胞(平均差 [MD] 1.94,95% 置信区间 [CI]-0.52,4.39;I2 94.52%;共 915 名妇女)和 pfNK 细胞(平均差 [MD] 2.12,95% 置信区间 [CI]-5.26,9.5;I2 96.59%;共 397 名妇女)的百分比无明显差异。然而,与对照组相比,子宫内膜异位症妇女的uNK细胞比例(MD 3.91,95% CI 1.63,6.19;I2 0%;共149名妇女)明显更高。研究还发现,与对照组相比,子宫内膜异位症妇女的 pNK 细胞(MD -8.01,95% CI -13,-3.02;I2 40.27%;共 187 名妇女)、pfNK 细胞(MD -9.94,95% C:-13.53,-6.34;I2 0%;共 110 名妇女)和 uNK 细胞(MD -12.1,95% CI -17.95,-6.27;I2 16.75%;共 104 名妇女)的细胞毒活性明显降低。同样,子宫内膜异位症妇女的 pNK 细胞细胞毒性汇集平均溶解单位(MD -2.77,95% CI -3.91,-1.63;I2 0%;共 74 名妇女)也明显低于对照组。结论不同样本(外周血、腹腔液和子宫内膜组织)中NK细胞细胞毒性的一致降低可能有助于了解子宫内膜异位症的发病机制。为uNK、pfNK和pNK细胞的细胞毒性以及uNK细胞的百分比建立标准参考值是确定它们在临床诊断和治疗中的潜在价值的先决条件。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
F&S reviews
F&S reviews Endocrinology, Diabetes and Metabolism, Obstetrics, Gynecology and Women's Health, Urology
CiteScore
3.70
自引率
0.00%
发文量
0
审稿时长
61 days
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