Possibilities of correction of the endometrial receptor profile in chronic endometritis

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Abstract

Background: A broad spectrum of endometrial pathology is linked to chronic endometritis, including infertility, pregnancy failure, and placenta-associated pathology. These conditions result in impaired morphogenesis across the entire spectrum of endometrial transformation. There is a lot of evidence about the treatment of chronic endometritis, but it is not always possible to restore its structural and functional characteristics. In recent years, the effect of a complex of exogenous natural antimicrobial peptides and cytokines (Superlymph) in the treatment of chronic endometritis has been the subject of intensive study.

Objective: To evaluate the endometrial receptor profile (estrogen receptors (ER) and progesterone receptors (PR)) in patients with chronic endometritis treated with exogenous natural antimicrobial peptides and cytokines (Superlymph).

Materials and methods: The study included patients aged 25–38 years with uterine factor infertility and severe chronic endometritis. All patients received antibacterial therapy in combination with exogenous natural antimicrobial peptides and cytokines (Superlymph). Histological and immunohistochemical studies of receptor profile and severity of chronic endometritis were performed.

Results: A statistically significant decrease in morphological manifestations and severity of chronic endometritis was noted in patients who underwent antibacterial therapy in combination with Superlymph. A statistically significant increase in ER and PR expression in the stromal component of the endometrium was verified (p<0.001). ER expression was shown to be 1.53 [1.33;1.66] times higher in the stromal component and PR expression was shown to be 1.25 [1.15 1.53] times higher (p<0.001). There was an inverse correlation between the expression of ER and PR in the stroma before treatment and the extent of their increase after treatment, rs=-0.91 and rs=-0.92 respectively (p<0.001).

Conclusion: In severe chronic endometritis, adequate timely antibacterial therapy in combination with exogenous natural antimicrobial peptides and cytokines (Superlymph) leads to a decrease in the severity of pathology and restoration of the endometrial receptor profile.

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About the authors

Gulrukhsor Kh. Tolibova

D.O. Ott Research Institute of Obstetrics, Gynecology and Reproduction; I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia

Email: gulyatolibova@yandex.ru
ORCID iD: 0000-0002-6216-6220

Dr. Med. Sci., Head of the Pathomorphology Department; Professor, S.N. Davydov Department of Obstetrics and Gynecology

Russian Federation, Saint Petersburg; Saint Petersburg

Tatyana G. Tral

D.O. Ott Research Institute of Obstetrics, Gynecology and Reproduction; Saint Petersburg State Pediatric Medical University, Ministry of Health of Russia

Author for correspondence.
Email: ttg.tral@yandex.ru
ORCID iD: 0000-0001-8948-4811

Dr. Med. Sci., Head of the Immunohistochemistry Laboratory of the Pathology Department; Professor, Department of Pathological Anatomy with a Course of Forensic Medicine

Russian Federation, Saint Petersburg; Saint Petersburg

Maka I. Kakhiani

D.O. Ott Research Institute of Obstetrics, Gynecology and Reproduction; I.I. Mechnikov North-Western State Medical University, Ministry of Health of Russia

Email: kakhiani74@mail.ru
ORCID iD: 0000-0001-6702-6350

PhD, Obstetrician-Gynecologist; Associate Professor, S.N. Davydov Department of Obstetrics and Gynecology

Russian Federation, Saint Petersburg; Saint Petersburg

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2. Fig. 1. Estrogen receptor (ER) expression in glands and endometrial stromal component before and after treatment

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3. Fig. 2. Progesterone receptor (PR) expression in glands and endometrial stromal component before and after treatment

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4. Fig. 3. Morphological profile of endometrium before CE treatment: a - mononuclear infiltration. G-E, x200; b - receptor expression (ER). IHC, x200; c - receptor expression (PR). IHC, x200

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5. Fig. 4. Morphological profile of CE before and after treatment: a - mononuclear infiltration. G-E, x200; b - receptor expression (ER). IHC, x200; c - receptor expression (PR). IHC, x200

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6. Fig. 5. Efficacy of CE therapy based on evaluation of the ratio of estrogen (ER) and progesterone (PR) receptor expression before and after treatment

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