Inflammatory markers in the normal and thin endometrium in chronic endometritis
Objective. To investigate the clinical and morphological characteristics of chronic endometritis (CE) in patients with the normal and thin endometrium in the dynamics of rehabilitation, by applying peloids.Marinkin I.O., Trunchenko N.V., Volchek A.V., Ageeva T.A., Nikitenko E.V., Makarov K.Yu., Kuleshov V.M., Omigov V.V., Aidagulova S.V.
Subjects and methods. The case-control study and the prospective cohort study were conducted in 240 patients aged 27.0±2.9 years with CE, including 118 cases with the normal endometrium (M-echo> 6 mm in the proliferative phase of the cycle) and 122 women with the thin endometrium (M-echo ≤ 6 mm), who were treated with vitamin therapy and physiotherapy (Scheme 1) and in combination with peloids (Scheme 2) from Lake Karachi (West Siberian Plain). Before and after treatment, the investigators conducted a clinical examination, endometrial ultrasonography, by assessing changes in the scores derived from the scale designed by M.N. Bulanov, a cultural study of cervical canal discharge and endometrial pipelle biopsy with an immunohistochemical (IHC) examination of the expression of CD138 plasma cells and СD20 B lymphocytes in 88 cases, including 24 biopsies that were analyzed using nonparametric statistics and multivariate analysis of variance.
Results. The data of the clinic, the scoring ultrasound characteristics of the endometrium, and the magnitude of inflammatory and cellular components in the uterine mucosal biopsy specimens in patients with CE and the normal endometrium after treatment revealed significant values in normalizing the menstrual cycle and improving fertility, as well as a decrease in the content of СD20- and СD138-positive cells. During rehabilitation in combination with peloids, the thin endometrium was characterized by the higher expression of inflammatory markers in the pipelle biopsy specimens along with positive clinical changes and growth of symbiotic microflora.
Conclusion. The use of peloids in the treatment of CE in women with the thin endometrium induces regeneration with the transient manifestation of IHC markers of inflammation.
Keywords
chronic endometritis
thin endometrium
inflammation
regeneration
CD138 plasma cells
immunohistochemistry
peloid therapy
Supplementary Materials
- Fig. 1. The results of the study of the culture method scraping the cervix in patients with chronic endometritis year up to and follows the rehabilitation
- Fig. 2. Changes in the growth rate Escherichia coli according culture studies discharge from the cervical canal during chronic endometritis before and after treatment in series in the 1st, 2nd, 3rd and 4th groups (p <0.00001)
- Fig. 3. Study of the dynamics IHC expression of markers of chronic endometritis and in patients with normal endometrial thickness (a) and a thin endometrium (b) with vitamin-mineral and physiotherapy in combination with peloids. Mean values, the method of Latin squares
- Table 1. Clinical characteristics of patients with chronic endometritis before and after treatment (absolute figures and the level of significance of differences p)
- Table 2. Levels of significance p CFU differences according to the culture method of estimating the content of microorganisms in the discharge of the cervical canal with chronic endometritis before and after the application of 2 regimens
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Received 11.08.2017
Accepted 22.09.2017
About the Authors
Marinkin Igor’ Olegovich, doctor of medical sciences, professor, the head of the Obstetrics and Gynecology Department, rector of Novosibirsk State Medical University. 630091, Russia, Novosibirsk, Krasny pr. 52. Tel.: +73832223204. E-mail: rector@ngmu.ruTrunchenko Natalia Victorovna, assistant of the Obstetrics and Gynecology Department, Novosibirsk State Medical University.
630091, Russia, Novosibirsk, Krasny pr. 52. Tel.: +79139429945. E-mail: trunchenko@yandex.ru
Volchek Alexandr Victorovich, physician of the Novosibirsk City Clinical Perinatal Center.
630089, Russia, Novosibirsk, Adriena Lezhena str. 32. Tel.: +79130031722. E-mail: alexvolchek@ yandex.ru
Ageeva Tatyana Avgustovna, doctor of medical sciences, professor of the Pathoanatomic Department, Novosibirsk State Medical University.
630091, Russia, Novosibirsk, Krasny pr. 52. Tel.: +79039375051. E-mail: ageta@mail.ru
Nikitenko Evgeniy Viktorovich, candidate of medical sciences, head of the Pathoanatomic Department of the Novosibirsk City Clinical Perinatal Center.
630089, Russia, Novosibirsk, Adriena Lezhena str. 32. Tel.: +79139033882. E-mail: evniki@yandex.ru
Makarov Konstantin Yuryevich, doctor of medical sciences, assistant professor of the Obstetrics and Gynecology Department, Novosibirsk State Medical University.
630091, Russia, Novosibirsk, Krasny pr. 52. Tel.: +73832229312. E-mail: fdpngma@mail.ru
Kuleshov Vitaliy Mihaylovich, doctor of medical sciences, professor of the Obstetrics and Gynecology Department, Novosibirsk State Medical University.
630091, Russia, Novosibirsk, Krasny pr. 52. Tel.: +73833410436. E-mail: kuleshov_vm@mail.ru
Omigov Vladimir Vilor’evich, candidate of medical sciences, senior researcher of laboratory of cellular biology and fundamental basis of reproduction,
Novosibirsk State Medical University. 630091, Russia, Novosibirsk, Krasny pr. 52. Tel.: +73832263560. E-mail: omigov@vector.nsc.ru
Aidagulova Svetlana Vladimirovna, doctor of biological sciences, professor, head of laboratory of cellular biology and fundamental basis of reproduction,
Central scientific laboratory, Novosibirsk State Medical University.
630091, Russia, Novosibirsk, Krasny pr. 52. Tel.: +79139092251. E-mail: s.aydagulova@gmail.com. ORCID 0000-0001-7124-1969
For citations: Marinkin I.O., Trunchenko N.V., Volchek A.V., Ageeva T.A., Nikitenko E.V., Makarov K.Yu., Kuleshov V.M., Omigov V.V., Aidagulova S.V. Inflammatory markers in the normal and thin endometrium in chronic endometritis. Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2018; (2): 65-73. (in Russian)
https://dx.doi.org/10.18565/aig.2018.2.65-73
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