Modulation of the local expression of innate immune factors in patients with chronic endometritis and infertility

Objective. To enhance the efficiency of therapy for chronic endometritis, by modulating the local expression of innate immune factors. Subjects and methods. A study group of 43 patients with chronic endometritis and a comparison group of 15 healthy women were examined. Endometrial material was obtained by aspiration biopsy. The immunohisto-chemistry technique was used to estimate the number of pinopodia, receptors, infectious agents, CD138, CD20, CD8, CD4, CD56, and HLA-DRII. The investigators applied an reverse transcription-PCR assay to evaluate the expression of TLR4, TLR2, HBD1, and TNFa and ELISA to measure the level of HNP1-3. A 20-day cycle of cytokine therapy with Superlymph was performed. Results. Epstein Bar virus was verified in 55.8% of the samples. After therapy, the number of pinopodia showed a 1.3-fold increase and the incidence of Epstein-Barr virus displayed a 2.2-fold decrease. The detection rates for CD138and CD20decreased by 1.6and 1.4 times, respectively. There were 1.7- and 1.5-fold increases in the levels of T-helpers and HLA-DRII, respectively; a 1.3-fold decrease in the expression of the TLR2 gene; the expression of the TLR4, TNFa, HBD1, and HNP1-3 genes increased by 1.5-, 1.2-, 2.1-, and 1.57-fold, respectively. Conclusion. Cytokine therapy leads to a 1.27-fold increase in the number of pinopodia;, there was a rise in the expression of TLR4 and HBD1 receptors by 5 times, TNF-a by 2.2 times, and HNP1-3 by 1.57 times. The diagnosis of active chronic endometritis was ruled out in 62.8% of patients; this condition advanced into an inactive stage in 37.2%.

TLR2, TLR4, chronic endometritis, infertility, cytokine therapy, TLR2, TLR4, defensin, tumor necrosis factor