Immune response in women with different morphological forms of chronic endometritis and impaired implantation


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Abstract

Objective: To investigate immune response in women with chronic endometritis and impaired implantation. Materials and methods: The study included 59 women with chronic endometritis managed for infertility and miscarriage and 48 healthy fertile women, previously examined in a separate study of local and systemic immunities. We used standard histological and immunoh istochem ical analysis of endometrial biopsy specimens to determine the number of lymphocytes carrying markers of HLA-DR+ activation and the number of lymphocytes expressing the B-cell marker CD20+. All women underwent immunological examination, including flow cytometry, DNA flow cytometry, and enzyme immunoassay. Results: There were local and systemic immunity changes in polypoid and lymphofollicular chronic endometritis, suggesting the autoimmune nature of inflammation in chronic lymphofollicular endometritis. Conclusion: Characteristic features of the local B-cell response in each group of chronic endometritis determine the nature of the inflammatory process. An aberrant immune-inflammatory response contributes to the restructuring of the endometrium, which is characteristic of polypoid or lymphofollicular types of chronic endometritis, causing the development of an autoimmune component in the lymphofollicular variant of chronic endometritis, alters the microenvironment of the blastocyst, and leads to impaired implantation and reproductive losses.

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About the authors

Elena A. Mikhnina

Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Email: emikhnina@yandex.ru
Dr. Med. Sci., Professor at the Department of Obstetrics and Gynaecology and Reproductology

Natalia I. Davydova

Nikiforov's All-Russian Center for Emergency and Radiation Medicine of the Emergencies Ministry of Russia

MD, PhD, Senior Researcher, Head of the Laboratory of Clinical Immunology

Vladimir A. Kazantsev

Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

MD, PhD Student at the Department of Obstetrics and Gynaecology and Reproductology

Vera N. Ellinidi

Nikiforov's All-Russian Center for Emergency and Radiation Medicine of the Emergencies Ministry of Russia

MD, PhD, Senior Researcher, Associate Professor, Head of the Laboratory of Morphological Research

Vitaly F. Bezhenar

Pavlov First Saint Petersburg State Medical University, Ministry of Health of Russia

Dr. Med. Sci., Professor, Head of the Departments of Obstetrics, Gynecology and Neonatology/Obstetrics, Gynecology and Reproductology

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