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Fig. 9 | BMC Medicine

Fig. 9

From: Deep immunophenotyping reveals endometriosis is marked by dysregulation of the mononuclear phagocytic system in endometrium and peripheral blood

Fig. 9

Proposed model of involvement of specific immune populations in the proliferative phase of the menstrual cycle in endometriosis patients compared to controls. The model shows that, in controls, there is a recruitment of immune cells during regenerative-proliferative phase of the menstrual cycle for endometrial regeneration and proliferation. In addition, there is less recruitment of classical and intermediate monocytes to the endometrium in controls, as the inflammation is not as enhanced in this tissue as it is in disease. The right panel shows the model in endometriosis. It shows that there is higher recruitment of immune populations (specifically classical and intermediate monocytes, which will differentiate to macrophages) to sites of inflammation, such as the endometriotic lesions and endometrium, decreasing like this the proportion of these monocytes in circulation of women with endometriosis. It also shows that there is a higher proportion of plasmacytoid dendritic cells and non-classical monocytes in circulation in women with endometriosis. Finally, we hypothesize that the increase of SIRPα in endometrial macrophages and dendritic cells might decrease the phagocytic capacity of these cells, by allowing endometrial cells to scape clearance during menses and regenerative phases of the cycle, which, in turn, would allow their migration to the peritoneal cavity, implant, and develop the endometriotic lesions

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