Objective: To study the prostanoid profile of the endometria of patients with recurrent implantation failure (RIF), unexplained infertility (UIF), and recurrent miscarriages (RM), and to compare them with the endometria of healthy fertile controls. Design: Prospective cohort study. Setting: University hospital. Patient(s): Fifteen patients with RIF, 18 patients with UIF, 16 patients with RM, and 23 fertile controls were recruited. Intervention(s): Endometrial samples were taken during the window of implantation. After tissue homogenization and extraction, analysis with ultra-performance liquid chromatography diode array detector electrospray ionisation tandem mass spectrometry was performed. Main Outcome Measures: Concentrations of prostaglandin (PG) D1,
Objective: The aim of the study is to assess local immune activation through B lymphocytes density and the presence of germinal centers in the vestibular mucosa of patients with localized provoked vulvodynia (LPV).Materials and Methods: Vestibulectomy specimens of 29 patients with LPV and colporrhaphy posterior specimens of 20 control women were included in the study. Immunohistochemical staining with CD20 antibodies for B lymphocytes were performed and subsequently, microscopical evaluation for B lymphocytes density and the presence of germinal centers was conducted.Results: B lymphocyte densities were higher in the vestibular mucosa of patients with LPV compared to control women (87 vs 21, p<0.01). The presence of germinal centers was only observed in the specimens of patients with LPV (0.31 vs 0, p<0.011).
Conclusion:The presence of germinal centers with increased B lymphocyte density underlines a local immune activation in the vestibule of patients with LPV. An abnormal germinal center response can trigger the pathway to the development of autoimmunity through the emergence of an autoreactive B cell clone and autoantibodies. LPV can potentially emerge as an autoimmune disease of the vestibule. More studies are needed to understand the pathophysiology of LPV and its association with autoimmunity.
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