ROLE OF TOLL-LIKE RECEPTORS IN THE PATHOGENESIS OF POSTPARTUM ENDOMETRITIS


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Abstract

Objective. To establish the role of toll-like receptors (TLR) 1, 2, 4, and 5 in the pathogenesis of postpartum endometritis. Subjects and methods. Forty-eight patients with signs of postpartum endometritis and 56 women with a normal postpartum period were examined. Epithelial cells taken from the cervical canal at 3—4 days postpartum were the material to be estimated for TLR expression. The latter was assessed using the quantitative polymerase chain reaction (PCR). Results. The patients with postpartum endometritis showed a significant reduction in the levels of TLR4 and TLR5, as well as the TLR signaling pathway proteins MyD88 and NF-kB. The expression of TLR1 and TLR2 did not significantly change. Lower NF-kB expression resulted in a reduction in the elaboration of proinflammatory cytokines and antimicrobial peptides onto the mucosal surface, which may promote the invasion of a pathogen even if the latter was modest. Conclusion. The reduced expression of TLR4 and TLR5 in the female genital tract epithelium may play a considerable role in the pathogenesis of postpartum endometritis as this favors the activation of the opportunistic flora due to diminished local immunological responsiveness.

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About the authors

O. P LEBEDEVA

Belgorod State University

Email: safonova2@yandex.ru

N. I SAMBORSKAYA

Belgorod State University

S. P PAKHOMOV

Belgorod State University

M. I CHURNOSOV

Belgorod State University

V. N POPOV

Voronezh State University

P. V KALUTSKY

Kursk State University

O. N IVASHOVA

Belgorod State University

N. A RUDYKH

Belgorod State University

I. N POLYAKOVA

Belgorod State University

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