ArticleMedical molecular morphology2021
Hemoglobin-induced continuous activation of macrophages in endometriotic cysts: a potential mechanism of endometriosis development and carcinogenesis.
Article in Medical molecular morphology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.
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Who cites it
5 citing papers in PubMed, 6 citations in OpenAlex.
- Endometriosis as a Systemic and Complex Disease: Toward Phenotype-Based Classification and Personalized Therapy.International journal of molecular sciences · 2026Review
- Immunohistochemical examination of CD163 and TROP2 expression levels in ovarian endometriosis.Journal of molecular histology · 2025Article
- Preventive role of CD163-positive macrophages in postoperative peritoneal adhesions.Inflammation and regeneration · 2025Article
- Female reproductive disease, endometriosis: From inflammation to infertility.Molecules and cells · 2025Review
- Endometriosis and the Role of Pro-Inflammatory and Anti-Inflammatory Cytokines in Pathophysiology: A Narrative Review of the Literature.Diagnostics (Basel, Switzerland) · 2024Review
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
Endometriosis is a chronic inflammatory disease. Endometriotic cysts contain hemoglobin (Hb) and infiltrated macrophages, indicating that the metabolism of Hb by macrophages may play an important role in the inflammation of endometriotic cysts. In this study, we investigated the distribution of immune cells and CD163 (Hb receptor)-positive cells in the endometriotic cyst wall using immunohistochemistry. We also examined the role of macrophage activation by Hb on the pathogenesis of endometriotic cysts by measuring the cytokine concentration in the cystic fluids and macrophage-culture supernatant using ELISA. Macrophages were the most prominent immune cells observed in the endometriotic cysts and were differentially distributed in the different histological areas of the cyst wall. The localization of CD163-positive macrophages was restricted to the hemorrhagic and outer areas in the cyst wall. High concentrations of IL-6 and CCL2 were found in the cystic fluids, and inflammatory cytokines (IL-6, TNF-α, and CCL2) were secreted from macrophages on stimulation by Hb. IL-6 is a promotional factor for endometriotic stromal cells and ovarian clear cell carcinoma, the most common histological subtype of endometriosis-related ovarian cancer, hence, the continuous activation of macrophages by Hb could be a potential mechanism underlying endometriosis development and carcinogenesis.
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