Aim. To assess the expression of vascular endothelial growth factor A for evaluating the functional state of the endometrium in women suffering from infertility and chronic endometritis.Materials and methods. Endometrium biopsy specimens obtained from 41 patients with uterine factor infertility (experimental group) were examined. A comparison group was composed of 39 women diagnosed with the “male factor” infertility exhibiting no infl ammatory processes of the reproductive organs. An endometrial biopsy was performed in both phases of the menstrual cycle: on days 8–10 of the follicular phase and on days 21–24 of the luteal phase. The expression of vascular endothelial growth factor receptors was evaluated on the basis of immunohistochemical staining of the biopsy specimens using monoclonal antibodies. The results of the immunohistochemical reaction were quantifi ed using the ImageJ software. A quantitative criterion — a stained area coeffi cient (per cent) representing the ratio of the immunohistochemical staining area to that of a biopsy specimen — was proposed for assessing the level of VEGF-A expression.Results. In the chronic endometritis group, the intensity of VEGF-A expression was found to be 1.4 times higher than that in the comparison group during the proliferation phase (p < 0.001). Expression values of the secretion phase were 1.9 times higher than those in the comparison group (p < 0.01).Conclusion. Chronic endometritis is characterized by an overexpression of VEGF-A by various endometrium cellular components. Interpretation of immunohistochemical stains using the method of computer morphometry allows quantitative indicators characterizing the intensity of angiogenesis marker expression in the endometrium during the menstrual cycle to be obtained. The level of VEGF-A expression can be used as an additional marker improving the quality of biopsy diagnostics in patients with infertility.
Background. Inflammation declares itself with the presence of cellular tissue infiltrate, which composition reflects the inflammation type. Chronic inflammation is predominated by mononuclear cell infiltration with a certain amount of neutrophils, which role and significance are not fully understood to date.Objectives. Assessment of the infiltrated neutrophil count at various chronic endometritis severity and its dependency on the functional and metabolic activity in neutrophilic leucocytes in peripheral blood.Methods. This prospective non-randomised controlled trial estimated the CD45+ leucocyte and activated CD16b+ neutrophil counts in inflammation infiltrate using immunohistochemistry protocols. Cell counts per section 1 mm2 were measured with computer morphometry. The content of and NADPH oxidase activity in activated neutrophilic leucocytes in venous blood were estimated with a nitroblue tetrazolium reduction test.Results. The study included 40 women with a history of chronic endometritis (CE) divided in two cohorts by endometrial biopsy data, with inactive (n = 25) and active CE (n = 15). A control cohort comprised 20 women with no signs of CE. The inactive CE cohort had higher counts of CD45+ leucocytes and activated CD16b+ neutrophils in infiltrate compared to control. Higher content of activated neutrophilic leucocytes with higher NADPH oxidase activity were found in peripheral blood. Morphological exacerbation markers of EC were associated with sharper peaks of CD45+ and CD16b+ cell counts in infiltrate and an elevated functional metabolic activity in circulating neutrophilic leucocytes. A strong direct correlation was revealed between blood activated neutrophil and endometrial CD16b+ neutrophil counts, as well as NADPH oxidase activity in blood neutrophils and infiltrate CD16b+ cell counts.Conclusion. Even minor morphological markers of exacerbated endometrial inflammation are accompanied by the elevated infiltrate counts of both total CD45+ leucocytes and activated CD16b+ neutrophils. The functional metabolic activity of peripheral blood neutrophilic leucocytes is interlinked with the inflammatory infiltrate cell composition and reflects severity of chronic endometrial inflammation.
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