CHANGES IN THE LOCAL AND SYSTEM IMMUNE RESPONSE IN WOMEN WITH CHRONIC ENDOMETRITIS

Aim: To analyze the features of changes in the immune response both at the local and systemic levels in patients with chronic endometritis (CE). Assess the state of cellular and immune components of the immune system in women with CE.

Materials and methods: The study reveals in detail the variability of immunological rearrangement in 450 women with different macro types of CE (hypoplastic, hyperplastic, mixed). The following indicators were analyzed to assess the state of the immune system: T-lymphocytes (CD 3+), B-lymphocytes (CD 20+), T-helpers (CD 4+), NK-cells (CD 16+), cytotoxic T-cells (CD 8+), rFAS-CD 95+ (apoptosis receptor), phagocytosis activity of monocytes and neutrophils. The above parameters were evaluated in the control group. There were 65 women with an early reproductive loss in history, but without chronic endometritis.

Results: The results of the data showed that the greatest decrease in resistance and inhibition of immunological rearrangement was observed in a cohort with a hyperplastic variant of CE. Hyperreactivity of the immune system was characteristic of women with mixed macro types. The pro-apoptotic orientation of changes, inhibition of cellular and humoral units was revealed in a cohort with hypoplastic macro types of CE. The role of persistent microbial pathogen in the development of immune deficiency was studied. The results of the study detail the importance of destructive-inflammatory, autoimmune processes, the imbalance of the cellular and humor parts of the immune system in the initiation and maintenance of CE.

Conclusions: The detailed study of the reaction of cellular and humoral defense factors, both at the local and systemic levels, will optimize the choice of pathogenetic therapy, interrupt the vicious cycle of persistent chronic inflammatory process in endometrial tissues, and also make an individual selection of rehabilitation measures in women with a complicated obstetric history.

Key words: chronic endometritis, immune response, macro types, immunological rearrangement, diagnostics.