P–744 The features expression of some lymphocyte markers in the pelvic peritoneal adhesions’ tissue at reproductive age women

2021 ◽  
Vol 36 (Supplement_1) ◽  
Author(s):  
A Sulima ◽  
G Puchkina ◽  
A Davydova
Keyword(s):  
Immune Response ◽  
T Lymphocytes ◽  
Transforming Growth Factor ◽  
Immunohistochemical Study ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Reproductive Age ◽  
Immunohistochemical Method ◽  
Women Of Reproductive Age ◽  
Peritoneal Adhesions

Abstract Study question To study the expression of CD4, CD8, CD20, CD 138 in the tissue of the pelvic peritoneal adhesions at women of reproductive age. Summary answer Immunohistochemical study of pelvic adhesions revealed the CD8-positive cells is directly involved in the formation of the immune response at the late stages of adhesiogenesis. What is known already One of the reason identifies the high frequency of adhesion formation is the presence of inflammation in the abdominal cavity with different severity and origin. It is known that Insufficiency of the fibrinolytic system, increased levels of a number of cytokines, including transforming growth factor- β1, and tissue hypoxia induce neoangiogenesis and fibrotization of the fibrin matrix, which leads to the formation of adhesions. Data on expression of CD4, CD8, CD20, CD138/syndecan–1 in the pelvic peritoneal adhesions in connection with their prescription, localization and origin is absent at accessible literature. Study design, size, duration Two hundred infertile women (aged 19–49 yrs) with pelvic peritoneal adhesions, who were underwent operative laparoscopy and adhesiolysis. Participants/materials, setting, methods The material for this study was the fragments of surgical material (adhesions and their parts) n = 200, taken from the women of reproductive age who suffered with infertility during operative laparoscopy.The morphological and immunohistochemical study of adhesions were carried out by standard techniques using paraffin blocks, reagents of Dako and monoclonal antibodies to CD4 (Clone 4B12 Ready-to-Use),CD8 (Clone C8/144B Ready-to-Use), CD20 (Clone L26 Ready-to-Use),CD138/syndecan–1 (Clone MI15 Ready-to-Use) of Abcam with automatic coloring Dako Cytomation. Main results and the role of chance To assess the population composition of these cell infiltrates, as well as individual diffusely located inflammatory cells, an immunohistochemical method with the main lymphocytic markers (CD4, CD8, CD20, CD138) was used. First of all, it is necessary to note the complete absence of CD20-positively colored cells in all observations, which indicates that at the final stage of the formation of adhesions, there is no element of the B-lymphocytic immune response. In an immunohistochemical study with syndecan–1 (CD138) antibodies, we identified a small number of positively colored cells that were located mainly perivascular, as part of mononuclear infiltrates. Quantitative analysis showed that the number of such cells is 0.8±0.2. When studying CD4–positive T-lymphocytes, it was found that they are usually located in the form of band-shaped infiltrates and focal perivascular clusters. The number of CD4-positive cells in the spike tissue is 5.6±0.2. CD8-positive cells were located mainly submesothelial, and in the form of perivascular clusters, the number of such cells was 9.2±0.6. Limitations, reasons for caution Age limitation, only women aged 19–49 yrs took part in this study. Exclusion criteria were the following for the groups: acute gynecological diseases, malignant diseases of female genitalia and ovarian tumors. Wider implications of the findings: The absence of B-cells in the “mature” adhesions’ tissue was found.The number of CD8-positive cells in our study was 1.5 times higher than the number of CD4-positive T-lymphocytes.CD4-positive T-lymphocytes play an important role and their number significantly prevails over the number of CD8-positive T-lymphocytes at the initial stages of adhesiogenesis. Trial registration number Case control study

scholarly journals Clinical pathogenic basis for anti-adhesive treatment for appendicular-genital syndrome in women of reproductive age

2020 ◽  
Vol 3 (4) ◽  
pp. 228-232
Author(s):  
V.V. Simrok ◽  
◽  
I.A. Popova ◽  
D.V. Mel’nikova ◽  
◽  
...  
Keyword(s):  
Pelvic Inflammatory Disease ◽  
Inflammatory Disease ◽  
Clinical Symptoms ◽  
Adhesion Formation ◽  
Fold Increase ◽  
Reproductive Age ◽  
Complex Treatment ◽  
Women Of Reproductive Age ◽  
Peritoneal Adhesions ◽  
Normal Ranges

Aim: to assess the efficacy of penicillamine for the complex prevention of pelvic peritoneal adhesions in appendicitis associated with the acute conditions of uterine appendages (appendicular-genital syndrome, AGS) based on the changes in the levels of hydroxyproline and the major clinical symptoms of pelvic inflammatory disease. Patients and Methods: 157 women of reproductive age with AGS who were urgently or routinely admitted to a gynecological or surgical hospital were examined. Comparison group women were prescribed with conventional anti-inflammatory treatment or surgery as needed. Study group women additionally received penicillamine 250 mg twice daily for a month. Pre- and post-treatment non-invasive assessment of the peritoneal adhesive process was performed by measuring the levels of protein-bound and free hydroxyproline. Treatment efficacy was evaluated after 1 month by the changes in hydroxyproline levels, major clinical symptoms, and ultrasound. Results: it was demonstrated that pelvic acute inflammatory disease results in > 1.5-fold increase in the levels of protein-bound and free hydroxyproline. Penicillamine as a component of the complex treatment for pelvic inflammatory disease reduces the levels of hydroxyproline to normal ranges. The changes in the major clinical symptoms and ultrasonic findings after penicillamine therapy were more significant compared to the standard treatment. Conclusions: penicillamine as a component of the complex treatment for pelvic inflammatory disease significantly accelerates the improvement of symptoms and remission as well as the formation of peritoneal adhesions. This prevents both pelvic adhesive disease and tubal- and peritoneal-factor infertility. KEYWORDS: appendicular-genital syndrome, inflammation, hydroxyproline, penicillamine, pelvic peritoneal adhesions, prevention, adhesion formation. FOR CITATION: Simrok V.V., Popova I.A., Mel’nikova D.V. Clinical pathogenic basis for anti-adhesive treatment for appendicular-genital syndrome in women of reproductive age. Russian Journal of Woman and Child Health. 2020;3(4):228–232. DOI: 10.32364/2618-8430- 2020-3-4-228-232.

scholarly journals FEATURES OF SYSTEM IMMUNITY IN WOMEN WITH ENDOMETRIOSIS AND GENITAL INFECTION

2019 ◽  
Vol 21 (5) ◽  
pp. 895-910
Author(s):  
L. F. Zaynetdinova ◽  
L. F. Telesheva ◽  
A. V. Koryaushkina ◽  
S. V. Kvyatkovskaya ◽  
E. A. Mezenceva ◽  
...  
Keyword(s):  
Immune Response ◽  
Cellular Immunity ◽  
Functional Activity ◽  
Statistical Processing ◽  
Mycoplasma Genitalium ◽  
Reproductive Age ◽  
Genital Infection ◽  
Blood Monocytes ◽  
Women Of Reproductive Age ◽  
Systemic Immunity

External genital endometriosis is an inflammatory, estrogen-dependent disease that develops predominantly in women of reproductive age and is characterized by the presence of pain syndrome and infertility. Today, endometriosis is one of the most common gynecological diseases in women of reproductive age, however, the etiology and pathogenesis of it are not completely clear. Violations of systemic immunity are most important in the pathogenesis of endometriosis. The literature data on the features of the immune response in endometriosis in combination with genital infection are few and contradictory. Purpose – to study the features of systemic immunity in women with external genital endometriosis and pathogens of genital infection.A total of 159 women with external genital endometriosis were examined. The main lymphocyte subpopulations, the functional activity of neutrophils and peripheral blood monocytes, and the content of cytokines in the blood serum were studied. A study of systemic immunity was performed in women with 1-2 and 3-4 stages of endometriosis, as well as depending on the presence of pathogens of genital infection. The presence of Chlamydia trachomatis, Ureaplasma spp., Mycoplasma genitalium, HSV1, 2/CMV, HPV in the endometrium, peritoneal fluid, and endometrioid heterotopies was determined. Statistical processing was performed using the IBM SPSS Statistics Version 22.2 statistical analysis software package.According to the results of the study, it was found that women with endometriosis of stages 1-2 show signs of systemic inflammation with a predominance of the Th2 type of immune response and inhibition of cellular immunity. A particular feature of HPV was an increase in T-NK lymphocytes, a decrease in IL-2 and neutrophil functional activity. The presence of Ureaplasma spp./Mycoplasma genitalium was characterized by a decrease in cellular immunity and an increase in T-NK cells. Only with HPV and Ureaplasma spp./Mycoplasma genitalium decreased synthesis of IL-2, IL-6. With 3-4 stages, the most significant changes in immunity were found in groups of women with genital infection. When HPV – a high level of IgA, increased IgM, IL-8. With Ureaplasma spp./Mycoplasma genitalium – inhibition of cellular immunity, high levels of IgA, reduction of neutrophil phagocytic activity.Thus, in women with endometriosis in the presence of pathogens of genital infection revealed features that may contribute to the development and progression of the disease. 

scholarly journals The role of the immune response in the etiopathogenesis of endometriosis

2021 ◽  
Vol 68 (1) ◽  
pp. 40-47
Author(s):  
Catalina Diana Stanica ◽  
◽  
Adrian , Neacsu ◽  
Romina Marina Sima ◽  
Raluca Gabriela Ioan ◽  
...  
Keyword(s):  
Immune Response ◽  
Chronic Pelvic Pain ◽  
Economic Consequences ◽  
Reproductive Age ◽  
High Morbidity ◽  
Women Of Reproductive Age ◽  
Cytokines And Chemokines ◽  
Altered Immune Response

Endometriosis is a benign, chronic, estrogen-dependent condition, present in 10% of women of reproductive age. The condition is associated with chronic pelvic pain and infertility that influence their quality of life, as well as married life and has important socio-economic consequences. Despite its high morbidity, its etiopathogenesis is incompletely known. A large number of studies suggest that the ability of endometrial implants to grow in ectopic locations may be correlated with the altered immune response towards the endometriotic tissue. There are enough data to show that immune system mediators, such as cytokines and chemokines, are playing key roles in the onset and olso on progression of endometriosis. There are studies that prove the association between endometriosis and autoimmune diseases. The present paper aims to investigate the implications of the immune response in the etiopathogenesis of endometriosis. The study of cellular or humoral immunity deficits, the presence of autoantibodies associated with this condition, can facilitate the understanding of the mechanisms that lead to the appearance and spread of endometriosis. We hope that this information will ultimately provide the basis for the development of new effective approaches in endometriosis management.

scholarly journals Understanding the Impact of Uterine Fibroids on Human Endometrium Function

2021 ◽  
Vol 9 ◽  
Author(s):  
Antonia Navarro ◽  
Maria Victoria Bariani ◽  
Qiwei Yang ◽  
Ayman Al-Hendy
Keyword(s):  
Transforming Growth Factor ◽  
Vascular System ◽  
Uterine Fibroids ◽  
Transforming Growth Factor Β ◽  
Uterine Wall ◽  
Reproductive Age ◽  
Menstrual Bleeding ◽  
Women Of Reproductive Age ◽  
Myometrial Cells ◽  
The Impact

Uterine fibroids (leiomyomas) are the most common benign gynecological tumors in women of reproductive age worldwide. They cause heavy menstrual bleeding, usually leading to severe anemia, pelvic pain/pressure, infertility, and other debilitating morbidities. Fibroids are believed to be monoclonal tumors arising from the myometrium, and recent studies have demonstrated that fibroids actively influence the endometrium globally. Studies suggest a direct relationship between the number of fibroids removed and fertility problems. In this review, our objective was to provide a complete overview of the origin of uterine fibroids and the molecular pathways and processes implicated in their development and growth, which can directly affect the function of a healthy endometrium. One of the most common characteristics of fibroids is the excessive production of extracellular matrix (ECM) components, which contributes to the stiffness and expansion of fibroids. ECM may serve as a reservoir of profibrotic growth factors such as the transforming growth factor β (TGF-β) and a modulator of their availability and actions. Fibroids also elicit mechanotransduction changes that result in decreased uterine wall contractility and increased myometrium rigidity, which affect normal biological uterine functions such as menstrual bleeding, receptivity, and implantation. Changes in the microRNA (miRNA) expression in fibroids and myometrial cells appear to modulate the TGF-β pathways and the expression of regulators of ECM production. Taken together, these findings demonstrate an interaction among the ECM components, TGF-β family signaling, miRNAs, and the endometrial vascular system. Targeting these components will be fundamental to developing novel pharmacotherapies that not only treat uterine fibroids but also restore normal endometrial function.

scholarly journals Autoimmune markers for non-invasive diagnosis of endometriosis in women

2020 ◽  
Vol 66 (2) ◽  
pp. 162-166
Author(s):  
I.V. Menzhinskaya ◽  
A.G. Melkumyan ◽  
S.V. Pavlovich ◽  
V.D. Chuprynin ◽  
L.V. Vanko ◽  
...  
Keyword(s):  
Immune Response ◽  
Chronic Disease ◽  
Wide Spectrum ◽  
Diagnostic Value ◽  
Reproductive Age ◽  
Igg Antibodies ◽  
Local Inflammation ◽  
Women Of Reproductive Age ◽  
Non Invasive ◽  
Gonadotropic Hormones

Endometriosis is a common estrogen-dependent chronic disease in women of reproductive age; it is associated with dysregulation of the immune response, local inflammation, and increased formation of autoantibodies. The aim of the study was to investigate the profile of autoantibodies in women with endometriosis and to evaluate their diagnostic value using new modifications of enzyme immunoassay. In women with endometriosis of stage III-IV (n=39), a wide spectrum of autoantibodies was detected, mainly of class G, including antibodies to endometrial antigens (tropomyosin 3, tropomodulin 3), the enzyme α-enolase, steroid (estradiol, progesterone) and gonadotropic hormones. At the same time, the frequency of detection of IgG antibodies to tropomyosin 3, α-enolase, estradiol and human chorionic gonadotropin and their levels in patients with endometriosis were higher than in healthy women (n=26) (p

Metastatic neuroendocrine tumour mimicking endometriosis highlights the importance of excision for tissue diagnosis

2019 ◽  
Vol 11 (2) ◽  
pp. 108-111
Author(s):  
Shian-Li Wong ◽  
Valerie To ◽  
Justin Lam ◽  
Alan Lam
Keyword(s):  
Neuroendocrine Tumour ◽  
Incidental Finding ◽  
Abdominal Cavity ◽  
Reproductive Age ◽  
Metastatic Tumour ◽  
Women Of Reproductive Age ◽  
Gynaecological Laparoscopy ◽  
Advanced Stage Cancer ◽  
Macroscopic Examination ◽  
Metastatic Neuroendocrine Tumour

Introduction: Endometriosis is a common gynaecological condition, usually presenting with pelvic pain or infertility in women of reproductive age. Diagnosis is made on histopathology of deposits excised during laparoscopy, given diagnosis solely made by macroscopic examination can be challenging for even experienced gynaecological surgeons. Case description: A 45-year-old during laparoscopy for fibroids is found to have peritoneal deposits resembling endometriosis. Histopathology reveals multifocal metastatic grade 1 neuroendocrine tumour of the appendix. Conclusion: This incidental finding highlights the importance of thorough examination of the appendix and abdominal cavity for unexpected pathology during gynaecological laparoscopy. Incidental finding of appendiceal pathology at time of laparoscopy for endometriosis is not uncommon; however, the finding of metastatic malignancy is far rarer. While several case studies have reported severe endometriosis mimicking advanced stage cancer, this is the first documented occurrence of an advanced, metastatic tumour, mimicking endometriosis.

scholarly journals Peculiarities of intrauterine pathological processes in women of the postmenopauseal period

2021 ◽  
pp. 16-23
Author(s):  
Tetiana Polishchuk ◽  
Serhii Vdovichenko ◽  
Oleksandra Lubkovska ◽  
Dmytro Ledin
Keyword(s):  
Postmenopausal Women ◽  
Stromal Cells ◽  
Endometrial Adenocarcinoma ◽  
Progesterone Receptors ◽  
Uterine Cavity ◽  
Reproductive Age ◽  
Immunohistochemical Method ◽  
Women Of Reproductive Age ◽  
Endometrial Polyps ◽  
Increased Risk

Aim of the research is studying the pecularities of the endometrium pathological processes in postmenopausal women on the basis of the hysteroscopy data evaluation, as well as conduction of histopathological and immunochemical studies. Materials and methods. To study the pecularities of intrauterine pathological processes, 100 postmenopausal women were selected and studied. All women underwent hysteroscopy with separate diagnostic scraping of the uterine cavity. Also, 10 samples of glandular-fibrous endometrial polyps (GFEP) in women of reproductive age and 9 samples of such pathology in the postmenopausal period were studied by immunohistochemical method, using 6 primary specific monoclonal antibodies. Results. The results showed that in 64 (64 %) postmenopausal women pathological changes of the endometrium were presented with GFEP, and in 2 patients (2 %) endometrial adenocarcinoma was found. It was also determined that the nuclei of epithelial and stromal cells of GFEP in postmenopausal women are characterized by lower expression of estrogen and progesterone receptors, compared with women with such formations in the reproductive age. In addition, it was found that in postmenopausal women the expression of the apoptosis inhibitor bcl-2 and aromatase P450 in the epithelial and stromal cells of GFEP was more expressed, and the expression of the Bах antigen, on the contrary, was significantly lower than in women of reproductive age. Conclusions. Fundamental molecular-biological differences of GFEP in postmenopausal women compared with women of reproductive age were revealed. It was found that in postmenopausal women there is a significantly lower dependence of such polyps on the effects of estrogen and progesterone. In addition, the data indicate an increased risk of neoplastic transformation in such women.

scholarly journals Effect of Bletilla striata on the Prevention of Postoperative Peritoneal Adhesions in Abrasion-Induced Rat Model

2019 ◽  
Vol 2019 ◽  
pp. 1-10 ◽  
Author(s):  
BoTong Liu ◽  
QiuHua Zhang ◽  
Xiao Wu ◽  
YanJun Fu ◽  
Hui Wang ◽  
...  
Keyword(s):  
Western Blot ◽  
Transforming Growth Factor Beta ◽  
Immunohistochemical Staining ◽  
Transforming Growth Factor ◽  
Smooth Muscle Actin ◽  
Abdominal Cavity ◽  
Enzyme Linked Immunosorbent Assay ◽  
Peritoneal Adhesions ◽  
Bletilla Striata ◽  
Masson Trichrome Staining

Postoperative peritoneal adhesions (PPAs) constitute a common complication of abdominal surgery with a high incidence. Bletilla striata (BS) is an important hemostatic drug used in China for nearly 2000 years. The purpose of this study was to investigate the effect of Bletilla striata on postoperative intestinal adhesion in rats. PPA was induced by cecal wall abrasion, and Bletilla striata was injected to observe its effect on adhesion in rats. The adhesion and inflammation score were assessed through visual observation and histopathologic evaluation. The levels of interleukin-1 (IL-1β), tumor necrosis factor (TNF-α), and interleukin-17F (IL-17F) in abdominal cavity and interleukin-6 (IL-6) in plasma were measured by enzyme-linked immunosorbent assay (ELISA) at 6 hours, 12 hours, 24 hours, and 1 week after operation. The tissue level of transforming growth factor beta-1 (TGF-β1) was also determined by ELISA on the seventh day after surgery. The expressions of collagen and TNF-α were, respectively, detected by Masson trichrome staining and immunohistochemical staining. The expression of TGF-β1 and alpha smooth muscle actin (α-SMA) was detected by Western blot. The result showed that Bletilla striata has obvious preventive effect on PPAs and celiac inflammation of PPAs. Bletilla striata could significantly reduce the level of IL-17F abdominal cavity and IL-6 in plasma. Masson trichrome staining and immunohistochemical staining results showed that Bletilla striata also decreased the expression of TNF-α and collagen. Western blot results showed that Bletilla striata decreased the expression of α-SMA and TGF-β1. Our results suggest that Bletilla striata decreased the development of abdominal adhesion in abrasion-induced model of rats and reduced the expression of the important substance which increased in PPAs. Bletilla striata can be further studied as a new and cheaper antiadhesive substance.

scholarly journals Complex Laparoscopic Myomectomy with Severe Adhesions Performed with Proper Preventive Measures and Power Morcellation Provides a Safe Choice in Certain Infertility Cases

2016 ◽  
Vol 2016 ◽  
pp. 1-4
Author(s):  
Jaime Alfaro-Alfaro ◽  
María de los Ángeles Flores-Manzur ◽  
Roberto Nevarez-Bernal ◽  
Rodrigo Ayala-Yáñez
Keyword(s):  
Transvaginal Ultrasound ◽  
Abdominal Cavity ◽  
Adhesion Formation ◽  
Uterine Fibroids ◽  
Malignant Cell ◽  
The United States ◽  
Laparoscopic Myomectomy ◽  
Peritoneal Adhesions ◽  
Bicornuate Uterus ◽  
Power Morcellation

Laparoscopic myomectomy offers a real benefit to infertile patients with uterine fibroids and peritoneal adhesions. The procedure requires a skilled surgeon and laparoscopy technique to minimize adhesion formation and other proven benefits. Restrictions arise since this procedure requires power morcellation for fibroid tissue extraction. Two years ago, the Food and Drug Administration in the United States of America (FDA) issued the alert on power morcellation for uterine leiomyomas, addressing the risk of malignant cell spreading within the abdominal cavity (actual risk assessment from 1 in 360 to 1 in 7400 cases). We review a 30-year-old female, without previous gestations, hypermenorrhea, intermenstrual bleeding, and chronic pelvic pain. Transvaginal ultrasound reports multiple fibroids in the right portion of a bicornuate uterus. Relevant history includes open myomectomy 6 years before and a complicated appendectomy, developing peritonitis within a year. Laparoscopy revealed multiple adhesions blocking uterine access, a bicornuate uterus, and myomas in the expected site. Myomectomy was performed utilizing power morcellation with good results. FDA recommendations have diminished this procedure’s selection, converting many to open variants. This particular case was technically challenging, requiring morcellation, and safety device deployment was impossible, yet the infertility issue was properly addressed. Patient evaluation, safety measures, and laparoscopy benefits may outweigh the risks in particular cases as this one.

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