Immune dysfunction in chronic endometritis and the experience of its correction using local cytokine therapy

Objective. To determine the current features of the etiology of chronic endometritis (CE) and to justify the need for combination treatment, including local cytokine therapy. Subjects and methods. A total of 128 patients with morphologically confirmed CE underwent determinations of viral and bacterial contamination of the uterine cavity by PCR, the levels of CD16 and CD56 lymphocyte subpopulations and HLA-DRII by an immunohistocytochemical method, and the proinflammatory cytokines TNF-a, IL-6, IL-8, and IFN-y by ELISA. The efficiency of local cytokine therapy with Superlymph was investigated in 30 patients with CE. The indicators were monitored in a group of 25 people without CE. Results. Viruses were found in 62.5% (80/128) of women with CE, which was two times as high as that in the control group (36% (9/25); p = 0.03). Mixed infections were detected in 81.3% (104/128) and 40% (10/25), respectively (p = 0.003). The immunohistochemical signs of CE with an autoimmune component during an exacerbation were observed in 96 (75%) cases; these in the remaining were indicative of remission in CE without an autoimmune component (p < 0.001). There were increases in the levels of proinflammatory factors: 3-fold in TNF-а, 2.7-fold in IL-6, 1.2-fold in IL-8, and 1.4-fold in IFN-y compared with those in the control group (p <0.05). After treatment with Superlymph, there were decreases in the levels of TNF-а, IL-6, and IL-8 by 2.4, 2.9, and 1.2 times, respectively (p <0.01), and IFN-y by 1.8 times (p = 0.04) compared with the pretreatment values. Conclusion. The investigation has revealed the high frequency of viral and bacterial infections in women with CE and an increase in the levels of proinflammatory cytokines. The use of Superlymph reduces the manifestations of the local endometrial inflammatory process and its autoimmune component.

chronic endometritis, immunity, cytokines, Superlymph