Association Between Impaired Dendritic Cell Maturation and Uterine Adenomyosis Pain

PURPOSE: To investigate the association between dendritic cell maturation deficits and pain in patients with adenomyosis and explore potential neuro-immune mechanisms. METHODS: Uterine tissues from 24 patients with adenomyosis (AM) and 15 controls were analyzed. Samples from the endometrial-myometrial interface (EMI) and middle myometrium (MM) were tested. To study the expression of nerve fiber marker (PGP9.5), nerve growth factor (NGF), mature DC (CD83+), and immature DC (CD1a+), the team used immunohistochemistry (IHC) and real-time quantitative reverse transcription polymerase chain reaction (qRT-PCR). The correlation between these findings and pain scores was also analyzed. RESULTS: PGP9.5 and NGF expression in both EMI and MM regions were significantly higher in the AM group (p < 0.05), whereas the CD83+/CD1a+ ratio was reduced (p < 0.01). A significant negative correlation was observed between PGP9.5 and the CD83+/CD1a+ ratio (MM: r = -0.650, p = 0.011; EMI: r = -0.812, p < 0.001). VAS scores (VAS) were negatively correlated with the CD83+/CD1a+ ratio (MM: r = -0.851, p < 0.001; EMI: r = -0.814, p = 0.001), but there was no direct association with NGF. Two-way analysis of variance (ANOVA) revealed that the disease state (AM) was the main factor affecting the proportion of NGF and DC maturation (p < 0.05), whereas anatomical location had no significant impact. CONCLUSIONS: Based on our cross-sectional observational study, DC maturation deficits are associated with AM pain, potentially through neuro-immune interactions. However, NGF functions independently of DC. Exploring neuro-immune interactions is a new approach for treating AM-related pain.