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16 December 2018

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Int J Med Sci 2015; 12(1):42-47. doi:10.7150/ijms.10076

Research Paper

Effect of Helixor A on Natural Killer Cell Activity in Endometriosis

In-Cheul Jeung, Youn-Jee Chung, Boah Chae, So-Yeon Kang, Jae-Yen Song, Hyun-Hee Jo, Young-Ok Lew, Jang-Heub Kim, Mee-Ran Kim

Department of Obstetrics and Gynecology, The Catholic University of Korea, Republic of Korea


Background and Aim: NK cells are one of the major immune cells in endometriosis pathogenesis. While previous clinical studies have shown that helixor A to be an effective treatment for endometriosis, little is known about its mechanism of action, or its relationship with immune cells. The aim of this study is to investigate the effects of helixor A on Natural killer cell (NK cell) cytotoxicity in endometriosis

Materials and Methods: We performed an experimental study. Samples of peritoneal fluid were obtained from January 2011 to December 2011 from 50 women with endometriosis and 50 women with other benign ovarian cysts (control). Peritoneal fluid of normal control group and endometriosis group was collected during laparoscopy. Baseline cytotoxicity levels of NK cells were measured with the peritoneal fluid of control group and endometriosis group. Next, cytotoxicity of NK cells was evaluated before and after treatment with helixor A. NK-cell activity was determined based upon the expression of CD107a, as an activation marker.

Results: NK cells cytotoxicity was 79.38±2.13% in control cells, 75.55±2.89% in the control peritoneal fluid, 69.59±4.96% in endometriosis stage I/II endometriosis, and 63.88±5.75% in stage III/IV endometriosis. A significant difference in cytotoxicity was observed between the control cells and stage III/IV endometriosis, consistent with a significant decrease in the cytotoxicity of NK cells in advanced stages of endometriosis; these levels increased significantly after treatment with helixor A; 78.30% vs. 86.40% (p = 0.003) in stage I/II endometriosis, and 73.67% vs. 84.54% (p = 0.024) in stage III/IV. The percentage of cells expressing CD107a was increased significantly in each group after helixor A treatment; 0.59% vs. 1.10% (p = 0.002) in stage I/II endometriosis, and 0.79% vs. 1.40% (p = 0.014) in stage III/IV.

Conclusions: Helixor A directly influenced NK-cell cytotoxicity through direct induction of CD107a expression. Our results open new role of helixor A as an imune modulation therapy, or in combination with hormonal agents, for the treatment of endometriosis.

Keywords: Endometriosis, Natural Killer cells, Cytotoxicity, Helixor

This is an open access article distributed under the terms of the Creative Commons Attribution (CC BY-NC) License. See for full terms and conditions.
How to cite this article:
Jeung IC, Chung YJ, Chae B, Kang SY, Song JY, Jo HH, Lew YO, Kim JH, Kim MR. Effect of Helixor A on Natural Killer Cell Activity in Endometriosis. Int J Med Sci 2015; 12(1):42-47. doi:10.7150/ijms.10076. Available from