Immune cells and
cytokines have important roles in the pathogenesis of
endometriosis. However, the production and role of
cytokines of T helper type 1 (Th1) and Th2 cells in the progress of
endometriosis have remained to be fully elucidated. The present study reported that the
interferon (IFN)-γ levels and the percentage of IFN-γ+CD4+ cells were significantly increased in the peritoneal fluid (PF) at the early stage and maintained at a higher level at the advanced stage of
endometriosis; furthermore,
interleukin (IL)-10 and IL-10+CD4+ cells were elevated in the advanced stage of
endometriosis. In addition,
IL-2 levels in the PF at the advanced stage of
endometriosis were elevated and negatively associated with IFN-γ expression. In a co-culture system of ectopic endometrial stromal cells (ESCs) and macrophages, elevated
IL-2 was observed, and treatment with
cytokines IL-2 and
transforming growth factor-β led to upregulation of the ratio of IL-2+ macrophages. IL-27-overexpressing ESCs and macrophages were able to induce a higher ratio of IL-10+CD4+ T cells. Blocking of
IL-2 with anti-IL-2
neutralizing antibody led to upregulation of the ratio of IFN-γ+CD4+ T cells in the co-culture system in vitro. Recombinant human
IL-10 and IFN-γ promoted the viability, invasiveness and transcription levels of
matrix metalloproteinase (
MMP)2, MMP9, and
prostaglandin-endoperoxide synthase 2 of ESCs, particularly combined treatment with
IL-10 and IFN-γ. These results suggest that
IL-2 and
IL-27 synergistically promote the growth and invasion of ESCs by modulating the balance of IFN-γ and
IL-10 and contribute to the progress of
endometriosis.