[The immune status of the endometrium in patients with abnormal uterine bleeding associated with chronic endometritis].

UNLABELLED: Chronic endometritis is widespread among women of reproductive age, it can be the cause of menstrual disorders, abnormal uterine bleeding and, finally, infertility of uterine genesis. The issue of impaired immune status of the glandular-stromal component in chronic endometritis has not been deeply investigated. Violation of the ratio of immune system cells is a fundamental link in the development of imbalance of the immunological status of the endometrium.

OBJECTIVE

To present a comparative analysis of the immune status of the endometrium in patients with abnormal uterine bleeding associated with chronic endometritis of varying severity.

MATERIAL AND

METHODS

A comparative analysis of clinical data, histological and immunohistochemical results of endometrial examination in 95 patients of reproductive age was carried out. Diagnosis of chronic endometritis was performed in histological sections: immunohistochemical reaction with CD138 antibodies with assessment of the number of plasma cells. In addition, the presence or absence of endometrial stromal fibrosis was recorded using Mallory staining. The following markers of endometrial lymphocytes were counted: CD4, CD8, CD20, CD56, and the CD4/CD8 ratio was estimated.

RESULTS

The morphological sign indicating changes in the immune status in patients with abnormal uterine bleeding associated with chronic endometritis is a significant increase in the number of lymphocytes characterised by increased expression of CD4, CD8, CD20, CD56 markers, and a disruption of the CD4/CD8 ratio, directly proportional to the degree of severity of chronic endometritis.

CONCLUSION

The study demonstrates statistically significant differences in immune status in patients with abnormal uterine bleeding associated with chronic endometritis of varying severity. Local immunity cells in the endometrium coordinate the menstrual cycle, and their imbalance leads to the activation of pathological mechanisms of endometrial immunoregulation, which is probably a pathogenetic factor of functional failure of the endometrium and menstrual disorders in women.