ANALYSIS OF PELVIC CELL POPULATIONS IN ENDOMETRIUM

Development of endometriosis appears to involve shedding of endometrial cells from the uterine cavity and implantation of the cells on ectopic pelvic loci. It is not known to what extend shedding of endometrial cells occurs in normal women at various stages of the menstural cycle or what factors may be involved in determining the biologic fate of these cells. Methodology used in the past has not allowed quantitative characterization of endometrial cells in the pelvic environment. The purpose of the present proposal is to test various biochemical cell markers for utility in parallel characterization of endometrial epithelial cells and inflammatory macrophages. This will be done by applying both conventional and newly developed marker techiques to endometrial and pelvic fluid aspirates and tissue samples of ectopic pelvic endometrial implants. The cell populations from endometrial aspirates, tissue samples and peritineal fluid will be characterized for a variety of enzyme, antigen and receptor markers using conventional cytochemical analysis and a flow cytofluorometric approach in parallel. The comparative analyiss of endometrial cells and inflammatory cells is important because preliminary studies suggest that pelvic macrophages are different in patients with endometriosis as compared to naormal women. The results of these studies will eventually show: 1. If any characteristic marker pattern distinguishable from normal can be found in aspirates of uterine endometrial cells or pelvic endometriotic implants in women with endometriosis. 2. If free endometrial cells in the peritoneal fluid are more closely related to cells in ectopic peritoneal implants or to cells in uterine endometrium in the same individual. 3. If physiologic cyclic changes exist in endometrial cells in peritoneal fluid in normal women or in patients with endometriosis during the menstrual cycle. 4. If biochemcial indicators of macrophage activation follow a physiologic or rhythmic pattern in each group of patients. 5. If pelvic macrophages from endometriosis patients are capable of inducing changes in adherence, cell growth, biochemical marker expression of normal endometrial cells when cocultured in vivo.