The correlation between the existence of serum autoantibodies and the risk of endometriosis: a systematic review and meta-analysis

Objective: Endometriosis is a common condition among women and can cause complications such as abdominal pain, dysmenorrhea, and infertility. One of the potential causes of this disease is autoimmunity. However, the evidence regarding the role of autoimmunity is conflicting and inconclusive. The aim of this study is to investigate whether autoantibodies, a sign of autoimmunity, are present in people suffering from endometriosis.
Materials and methods: Relevant studies up to April 14, 2023 were identified by systematically searching Scopus, PubMed, Web of Science, Embase, and Google Scholar. This meta-analysis includes all qualified case-control studies of human populations that analyze the association between serum autoantibodies and endometriosis patients. The odds ratios and 95% confidence intervals were computed. Additionally, heterogeneity and publication bias were examined, and subgroup analyses were performed based on region and target antigens.
Results: Forty-one studies were included, comparing 2825 Endometriosis patients to 4158 healthy controls. The meta-analysis findings indicated a significant association between the presence of autoantibodies in the serum and an increased susceptibility to endometriosis (OR: 4.242, CI 95%: 3.824-4.706, P< 0.001). Also, it has been found that there is a significant correlation between the presence of endometriosis and the serum levels of anti-nuclear antibodies (ANA), B2 glycoprotein 1, CA125, carbonic anhydrase I, cardiolipin, endometrial, laminin-1, smooth muscle, and syntaxin autoantibodies. Upon further analysis, it has been found that the serum levels of these autoantibodies are higher in patients with endometriosis from North America, compared to those from other regions (P= 0.001).
Conclusion: The study has revealed a significant correlation between serum autoantibodies and susceptibility to endometriosis, highlighting autoimmunity as a potential cause.