José Reis, doctorate degree in Medicine with distinction

José Lourenço Reis, Hospital da Luz specialist in Gynaecology-Obstetrics, concluded his doctorate degree in Medicine, last April 1, at the School of Medical Sciences / Nova Medical School (FCM/NMS), Lisbon Nova University, receiving the unanimous approval of the jury with distinction.

His thesis, entitled "Inhibitory receptors of immune cells and endometriosis", was focused on the study of immune dysfunction associated with endometriosis, with particular emphasis on NK cells (natural killer) and T lymphocytes, as well as the role of inhibitory receptors PD-1 (Programmed Cell Death Protein 1) and TIM-3 (T-cell Immunoglobulin and Mucin Domain 3).

The work involved the analysis of immune profiles in the peritoneal fluid and peripheral blood of patients with endometriosis, compared to a control group. "The results suggest that immunological imbalances at the level of these receptors may compromise an effective elimination of ectopic endometrial cells, favouring a chronic inflammatory state that is a characteristic of the disease", explains José Reis. Hence, this study represents "a contribution for the advancement of knowledge in the area of endometriosis immunology and may pave the way for new therapeutic approaches, centred on immune system modulation".

Main conclusions of the research:

• The function of NK cell receptors is determining in the immune response, being crucial for the detection and elimination of abnormal cells. In endometriosis, this function is compromised, with a reduction of immune surveillance and increase of suppression, which favours the disease persistence.
• The increased expression of PD-1 in peritoneal fluid NK cells compromises local action, hindering the elimination of endometriotic cells by the immune system and contributing to the progression of the disease.
• T-cells with decreased expression of TIM-3 lose part of their regulatory capacity, promoting an uncontrolled inflammatory environment in the deployment areas of endometriotic cells. This alteration is associated to recurrent inflammatory episodes and progression of the disease, being particularly evident in cases of grade III and IV endometriosis, and in patients with intestinal involvement, which suggests a correlation between the severity of the disease and the extent of immune dysfunction.

In the photo above, the new doctor and the jury: Jorge Lima FCM/NMS, and thesis advisor), Maria de Fátima Serrano (FCM/NMS), Hélder Ferreira (Abel Salazar Biomedical Sciences Institute, Oporto University), Luís Pereira da Silva (FCM/NMS, and president of the jury), Cristina Nogueira da Silva (Faculty of Medicine, Minho University), and Maria João Carvalho (Faculty of Medicine, Coimbra University).

The research work has had as co-advisors Luís Miguel Borrego (FCM/NMS) and Catarina Martins (FCM/NMS).

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