{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,28]],"date-time":"2026-01-28T12:30:03Z","timestamp":1769603403834,"version":"3.49.0"},"reference-count":31,"publisher":"Korean Society of Obstetrics and Gynecology","issue":"1","license":[{"start":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T00:00:00Z","timestamp":1764288000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100007338","name":"All India Institute of Medical Sciences","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100007338","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["ogscience.org"],"crossmark-restriction":true},"short-container-title":["Obstet Gynecol Sci"],"published-print":{"date-parts":[[2026,1,15]]},"abstract":"<jats:p>ObjectiveDysregulation of leukocyte cell number as a cause of heavy menstrual bleeding (HMB) has not been investigated much. The present study compares the changes in the number of uterine natural killer (uNK) cells, T cells, and macrophages in endometrial samples from women with normal menstrual cycles versus those with HMB.MethodsWe analyzed endometrial tissue from 98 patients (73 with HMB; 25 with normal cycles) using immunohistochemistry to semi-quantitatively estimate the degree of cluster of differentiation (CD)56+, CD8+, CD4+, and CD68+ cell infiltration.ResultsNo statistically significant differences were observed in the CD4+, CD8+, CD56+, or CD68+ cell counts between women with HMB and controls during either the proliferative or secretory phases of the menstrual cycle. CD56+ natural killer cells were relatively reduced in the HMB group during the proliferative phase, with higher counts in the control group (P=0.071). CD68+ macrophages\/high-power field (hpf) showed a strong positive correlation with CD4+ T cells (r, 0.481; P&lt;0.001), CD8+ T cells (r, 0.641; P&lt;0.001), and CD56+ uNK cells (r, 0.404; P&lt;0.001). CD8+ cells\/hpf demonstrated a significant positive correlation with uterine volume, CD4+ cells\/hpf, CD68+ cells\/hpf, and CD56+ cells\/hpf.ConclusionAlthough no single immune cell type was independently associated with HMB compared with controls, the observed significant correlations among CD4+, CD8+, CD56+, and CD68+ highlight the interconnected nature of endometrial immune activity.<\/jats:p>","DOI":"10.5468\/ogs.25196","type":"journal-article","created":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T00:12:56Z","timestamp":1764547976000},"page":"72-84","update-policy":"https:\/\/doi.org\/10.5468\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Uncovering immune signatures of the endometrium in heavy menstrual bleeding: a cross-sectional study"],"prefix":"10.5468","volume":"69","author":[{"given":"Mishu","family":"Mangla","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9956-2246","authenticated-orcid":true,"given":"Seetu","family":"Palo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Poojitha Kalyani","family":"Kanikaram","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Raja Shekar","family":"P","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aparna","family":"Setty","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"3425","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ajog.2022.10.008"},{"key":"ref2","first-page":"183","volume-title":"Endometrial macrophages in health and disease","author":"Brown","year":"2022"},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2265.2001.01432.x"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.02317"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1038\/s41574-021-00629-4"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.3109\/13697137.2014.963964"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.3389\/frph.2022.820029"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.12666"},{"key":"ref9","volume-title":"","year":"c2018"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.1093\/fampra\/cmx050"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1001\/jamapediatrics.2019.5040"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1016\/j.jri.2015.09.001"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dev067"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1159\/000320336"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1002\/j.2205-0140.2015.tb00020.x"},{"key":"ref16","doi-asserted-by":"publisher","DOI":"10.1007\/s00261-020-02567-7"},{"key":"ref17","volume-title":"","year":"c2022"},{"key":"ref18","volume-title":"","author":"Core Team","year":"c2021"},{"key":"ref19","volume-title":"","author":"Fox","year":"c2024"},{"key":"ref20","volume-title":"","author":"Ripley","year":"c2024"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.5603\/fm.a2019.0095"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2019.02387"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.5468\/ogs.23120"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2020.00246"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1111\/j.1600-0897.1988.tb00208.x"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3389\/fimmu.2022.918550"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.1016\/j.cytogfr.2024.11.007"},{"key":"ref28","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/deae137"},{"key":"ref29","doi-asserted-by":"publisher","DOI":"10.1093\/humupd\/6.1.16"},{"key":"ref30","first-page":"564","volume-title":"The endometrial immune environment of women with endometriosis","author":"Vallv\u00e9-Juanico","year":"2019"},{"key":"ref31","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2010.04.053"}],"container-title":["Obstetrics &amp; Gynecology Science"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/ogscience.org\/upload\/pdf\/ogs-25196.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ogscience.org\/journal\/view.php?doi=10.5468\/ogs.25196","content-type":"unspecified","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/ogscience.org\/upload\/pdf\/ogs-25196.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T23:01:08Z","timestamp":1769554868000},"score":1,"resource":{"primary":{"URL":"http:\/\/ogscience.org\/journal\/view.php?doi=10.5468\/ogs.25196"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,1,15]]},"references-count":31,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,1]]}},"URL":"https:\/\/doi.org\/10.5468\/ogs.25196","relation":{},"ISSN":["2287-8580"],"issn-type":[{"value":"2287-8580","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,1,15]]},"assertion":[{"value":"2025-06-19","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-10","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2025-11-28","order":2,"name":"published","label":"Published online","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-01-15","order":3,"name":"published","label":"Print publication","group":{"name":"publication_history","label":"Publication History"}}]}}