There is increasing evidence that autoimmune phenomena, including auto-antibody production, may affect fertility in women with endometriosis. The aims of this study are to evaluate anti-laminin-1 antibody (aLN-1) presence in sera and in follicular fluids (FF) of women with endometriosis undergoing IVF and its impact on oocyte maturation and IVF outcome. aLN-1 were measured by a home-made enzyme linked immunosorbent assay in sera and FF obtained from 35 infertile women with endometriosis and in sera from 50 fertile controls and 27 infertile women without endometriosis (IWWE). aLN-1 serum levels were significantly higher in women with endometriosis in comparison with both fertile controls and IWWE (P<0.001 and P<0.05, respectively) and a positive correlation was found between serum- and FF-aLN-1 (r=0.47, P=0.004). According to the cut-off (mean+3 SD of fertile controls), 31% of women with endometriosis were aLN-1 positive. Metaphase II oocyte counts showed inverse correlation with FF-aLN-1 levels (r=-0.549, P=0.0006). Ongoing pregnancy (i.e pregnancy progressing beyond the 12th week of gestation) occurred in 4/11 aLN-1 positive patients and in 7/24 aLN-1 negative with no significant difference (P=0.7). In conclusion, our results highlight that aLN-1 are increased in women with endometriosis and their presence in FF may affect oocyte maturation leading to a reduced fertility. However, aLN-1 seem to have no effect on IVF outcome.

Le malattie del sistema immunitario possono dividersi in patologie da difetto della risposta (immunodeficienze primitive o acquisite) e patologie in cui la risposta risulta abnorme, o perché rivolta contro antigeni esterni che normalmente non evocano risposte (allergie) o perché rivolta contro strutture “self “ verso le quali viene persa la tolleranza immunologica (malattie autoimmuni). Le immunodeficienze (ID) sono malattie causate da un deficit più o meno marcato della risposta immune. Sono caratterizzate da frequenti episodi infettivi ed hanno uno spettro variabile di gravità. Vengono normalmente divise in ID primitive o congenite (IDP) e secondarie o acquisite (IDS), tra le quali è compresa la sindrome da immunodeficienza acquisita (AIDS). Quando la risposta immunitaria è inappropriata, esagerata e dannosa per l’individuo si parla di ipersensibilità. Le reazioni da ipersensibilità vengono classificate in quattro tipi, ognuno dei quali riconosce un meccanismo patogenetico diverso ed è in grado di causare particolari malattie.