Relationships between intrauterine infusion of N-acetylcysteine, equine endometrial pathology, neutrophil function, post-breeding therapy, and reproductive performance

Gores-Lindholm, Alicia R.; LeBlanc, Michelle M.; Causey, Robert; Hitchborn, Anna; Fayrer-Hosken, R.A.; Kruger, Marius; Vandenplas, Michel L.; Flores, Paty; Ahlschwede, S.A.

doi:10.1016/j.theriogenology.2013.03.026

Cited by 23 publications

(17 citation statements)

References 40 publications

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“…Ecbolic hormones such as PGF2a and OXT have been used to promote mare uterine contractility in mares in some pathologic conditions. In fact, post-mating uterine lavage and OXT treatment have been reported to improve fertility rate in mares (Gores-Lindholm et al 2013), or as a treatment for post-breeding delayed uterine clearance in mares susceptible to endometritis (LeBlanc et al, 1994).…”

Section: Ecbolic Hormones and Diseasementioning

confidence: 99%

Dual effect of hormones on mare reproductive physiology and dysfunction

Rebordão¹,

Amaral²,

Galvão³

et al. 2016

PHK

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Summary: In the last decades, classical and molecular biology approaches have greatly contributed for building up sound knowledge on the mechanisms regulating reproductive processes in the mare. Different perspectives on the role of hormones should be addressed and thus considered by both researchers and clinicians. While oxytocin is largely used as a post-insemination method to improve fertility or prevent endometritis, it may also be considered to prolong the luteal phase. Prostaglandin E2 (PGE2), known to sustain luteostasis, has also been related to inflammatory processes in sub-clinical endometritis in mares. In contrast, as other ecbolic agents, PGF2a besides being luteolytic and currently used for estrous cycle shortening and endometritis control, might also play a role in fibrogenesis in mare endometrium. Hormones, like oxytocin, ovarian steroids, prostaglandins (PG), as well as enzyme profiles involved in endocrine pathways may act in a dissimilar fashion, depending on the estrous cycle phase and on the physiologic or pathologic condition.Keywords: mare / reproduction / oxytocin / prostaglandin / endometrium / fibrosis / ovarian steroids Doppeleffekt von Hormonen auf die Reproduktionsphysiologie und -störung bei der StuteIn den letzten Jahrzehnten haben die klassischen und molekularbiologische Methoden in hohen Maße für die Entwicklung fundierten Wissens zu den Regelmechanismen reproduktiver Prozesse bei der Stute beigetragen. Es sollten die unterschiedliche Sichtweisen auf die Rolle der Hormone berücksichtigt werden, sowohl von Forschern als auch Klinikern. Während Oxytocin überwiegend als Verfahren nach der Insemination verwendet wird, um die Fruchtbarkeit zu verbessern oder eine Endometritis zu verhindern, kann es auch eingesetzt werden, um die Gelbkörperphase zu verlängern. Prostaglandin E2 (PGE2) ist bekannt, die Luteostase zu erhalten, wird aber auch mit entzündlichen Prozessen bei der equinen subklinische Endometritis in Verbindung gebracht. Im Gegensatz dazu könnte PGF2a, wie andere ekbolische Mittel, abgesehen davon, dass es luteolytisch wirkt und derzeit benutzt wird, den Ovarialzyklus zu verkürzen und eine Endometritis zu kontrollieren, auch eine Rolle bei der Fibrogenese im equinen Endometrium spielen. Hormone wie Oxytocin, Ovarialsteroide, Prostaglandine (PG), als auch Enzymprofile, die an endokrinen Regelkreisen beteiligt sind, können in einer unterschiedlichen Art und Weise wirken, abhängig von der Zyklusphase und dem physiologischen oder pathologischen Zustand.

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Section: Ecbolic Hormones and Diseasementioning

confidence: 99%

Dual effect of hormones on mare reproductive physiology and dysfunction

Rebordão¹,

Amaral²,

Galvão³

et al. 2016

PHK

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“…The NAC-treatments were associated with a high pregnancy rate of 85 % (GoresLindholm et al 2009). In a subsequent study (Gores-Lindholm et al 2013), 154 client-owned mares were assigned to one of the three breeding management groups: 1) 44 repeat breeders with mucus overproduction were treated with 3.3 % NAC 24 -36 h before mating followed by OT 4 to 8 h later; 2) 85 reproductively normal mares; 3) 25 mares previously treated for endometritis. The first-cycle pregnancy rates for groups 1, 2 and 3 were 77 %, 74 % and 56 %, respectively, and early embryonic death rates were 15 %, 13 % and 7 %.…”

Section: Dimethyl Sulfoxidementioning

confidence: 99%

Update on endometritis therapy

Katila¹

2016

PHK

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IntroductionThe corner stones of equine endometritis therapy are still antimicrobials and support of uterine evacuation. Chelating agents are recommended to increase the effect of antibiotics particularly in biofilm producing organisms. The use of mucolytics has increased and kerosene and DMSO have been replaced by N-acetylcysteine. Immunomodulators, corticosteroids and cell-wall extracts, are the recent additions to our toolkit. Platelet-rich-plasma is the newest therapeutic method but needs still more research. Platelet-rich plasmaPlatelet-rich plasma (PRP) is autologous blood plasma that has been enriched with platelets by centrifugation. It contains -and releases through degranulation -several different growth factors and cytokines that stimulate tissue repair. Although PRP is used in many indications in human medicine, large-scale controlled clinical trials are lacking.Three abstracts have been published about the treatment of equine endometritis using PRP. Metcalf and Troedsson (2012) used 9 barren mares with a history of persistent mating induced endometritis (PMIE). The mares were inseminated and an endometrial biopsy was obtained the following day. All mares underwent an untreated cycle followed by a PRP-treated cycle. The mRNA expression of interleukins (IL) 1b, 6 and 8 and inducible nitric oxide synthase (iNOS) was significantly downregulated in the treated cycle as compared to the non-treated cycle. In the next experiment, Metcalf (2014) had 16 mares that had been barren for >2 years. The mares underwent a non-treated cycle and a cycle where 10 ml of PRP was infused into the uterus before insemination (AI). Pregnancy rate in the treated cycle was significantly higher than in the non-treated cycle (67 vs 19 %) and accumulation of intraluminal fluid was significantly less (22 vs 100 %). Reghini et al. (2014) inseminated 15 resistant and 8 susceptible mares in two cycles: treated and non-treated. In the treatment cycle, the mares received 20 ml of PRP into the uterus 4 h after AI. The resistant mares showed no differences between the cycles in NO concentration or in intrauterine (IU) fluid accumulation, but neutrophils in cytology diminished during the treated cycle. In susceptible mares, a significant decrease was observed after PRP treatment in the three parameters examined. All three experiments were conducted with a small number of mares, so no definite conclusions can be drawn. However, PRP might be worth trying to control PMIE in problem mares that do not seem to benefit from standard treatments. Immune modulatorsThe breeding induced inflammation involves chemokine-initiated recruitment of neutrophils to the uterus leading to the removal of excess spermatozoa and pathogens. There is a delicate balance between pro-and anti-inflammatory cytokines. Susceptible mares appear to have altered expression of cytokines, particularly a deficit in the production of anti- Summary: The corner stones of equine endometritis therapy are still antimicrobials and support of uterine evacuation. Ecbolic hormones, oxyt...

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“…Excessive mucus secretion by the endometrium may contribute to infertility, because of delaying the passage of sperm to the oviduct, resulting in uterine fluid accumulation and may be irritating to the epithelium of endometrium (LeBlanc & Causey, 2009). Gores-Lindholm et al (2013) administered intrauterinely 3.3% NAC solution (30 mL of 20% NAC added to 150 mL of sterile saline) 24-36 h before breeding in infertile mares who produced a lot of mucus in the uterus. After breeding, uterus flushing with solutio Ringeri was performed, oxytocin was administered and ceftiofur was given if needed.…”

Section: Mucolytic Agentsmentioning

confidence: 99%

“…Taking into consideration the above results, the authors demonstrate that NAC improves pregnancy rates in mares with higher mucus secretions in uterus. Furthermore, 3.3% NAC was administered intrauterinely in healthy mares and no changes in endometrium, only reduction of mucus amount were observed (Gores-Lindholm et al, 2013). N-acetylocysteine is a mucolytic agent which reduces viscosity of mucus by breaking the cross-linking disulphide bridges between mucin polymers.…”

Section: Mucolytic Agentsmentioning

confidence: 99%

“…N-acetylocysteine is a mucolytic agent which reduces viscosity of mucus by breaking the cross-linking disulphide bridges between mucin polymers. Moreover, NAC has antioxidant, anti-inflammatory and probably antibacterial properties (Zuin et al, 2005;Gores-Lindholm et al, 2013). However, further investigations are necessary to confirm NAC impact on pregnancy rates in mares with a history of infertility (LeBlanc & Causey, 2009).…”

Section: Mucolytic Agentsmentioning

confidence: 99%

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Non-traditional treatments for endometritis in mares

Buczkowska¹,

Kozdrowski²,

Sikora³

et al. 2015

BJVM

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SummaryBuczkowska, J., R. Kozdrowski, M. Sikora, M. Dzięcioł & A. Matusz, 2015. Non-traditional treatments for endometritis in mares. Bulg. J. Vet. Med., 18, No. 4,[285][286][287][288][289][290][291][292][293] Routine treatment for persistent mating-induced endometritis is directed at enhancing the clearance of accumulated fluid from the uterus and includes the use of ecbolic agents (oxytocin, prostaglandin F 2a ) which may be used alone or in combination with large-volume uterine lavage and administering antimicrobials if infection is diagnosed. However, traditional therapies are not always effective in resolving chronic uterine inflammation or infections. Treatment failure may be caused by uterine exudates, inspissated mucus or biofilm produced by some bacteria and yeast. Exudate can interfere with antibiotic penetration, whereas biofilm can confer antibiotic resistance. The endometrium of mares with delayed uterine clearance or chronic endometritis produces more mucus than reproductively healthy mares. Loss of cilia and abnormal mucus blanket provide areas for bacterial attachment. This review describes new strategies of endometritis treatment that may be added to typical therapy and includes intrauterine mucolytics, chelators, immunomodulators, corticosteroids, nonsteroidal antiinflammatory drugs and others.

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Relationships between intrauterine infusion of N-acetylcysteine, equine endometrial pathology, neutrophil function, post-breeding therapy, and reproductive performance

Cited by 23 publications

References 40 publications

Dual effect of hormones on mare reproductive physiology and dysfunction

Dual effect of hormones on mare reproductive physiology and dysfunction

Update on endometritis therapy

Non-traditional treatments for endometritis in mares

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