A comparison of Toll-like receptors and cytokine profiles in the endometrium around the time of implantation between women with and without chronic endometritis
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AbstractStudy question: Does the presence of chronic endometritis (CE) affect the expression of Toll-like receptors (TLR) and inflammatory cytokine profiles in endometrial tissues around the time of implantation?
Summary answer: The expression of TLR1, 2, 3, and 4 and Interferon gamma (IFN-γ) in the endometrial tissues of women with CE was higher than without CE.
What is known already: The prevalence of CE has been found to be higher in women with recurrent miscarriage and recurrent implantation failure. However, the exact mechanism whereby implantation is affected in women with CE is largely unknown. One earlier study showed the expression of TLR4 was increased in women with CE. Another study showed the alteration of cytokine profiles in CE patients. However, in these earlier studies, the validity of the observations has been questioned because the specimens were not precisely timed, and because it is well recognized that TLRs and cytokine profiles change throughout the cycle.
Study design, size, duration: This is a non-interventional observational study on the expression of 10 TLRs and 17 different inflammatory cytokines in precisely timed endometrial tissue collected from 83 women with reproductive
failure. Participants/materials, setting, methods: Endometrial tissue was collected from participants seeking treatment for infertility. All specimens were collected on day LH+7. Chronic endometritis was defined as plasma cell density
above normal range established from a fertile control population (> 5.15 CD138+ plasma cells/0.1 mm2, Liu Y et al., in press). TLRs 1-10 were stained by conventional immunohistochemistry for each specific antibody. In addition, 17 different inflammatory cytokines were analysed with the Luminex technique (Millipore, Billerica, MA) following protein extraction. Main results and the role of chance: Among 83 patients studied, 19 were found to have CE, and the other 64 did not have CE. There was no difference in age, duration of infertility, and the number of miscarriage between these two groups. In women with CE, the endometrial expression of some TLRs was significantly altered. In particular, stronger expression of TLR 1, 2, 3, and 4 were observed in endometrial epithelial and glandular cells when compared with women without CE. Among the 17 cytokines examined, the expression of IFN-γ in women with
CE was 3.69 pg/mL, which was significantly higher (p = 0.034) than that of in women without CE, 3.47 pg/mL. However, there was no statistically significant difference found among the other 16 cytokines and chemokines (EGF, G-CSF, GM-CSF, IL-10, IL-12P40, IL-12P70, IL-13, IL-1α, IL-1β, IL-2, Il-4, IL-5, IL-6, MCP-1, MIP-1β and TNF-α) studied. The data indicate that altered amount of IFN-γ in human endometrium with CE may be a result of higher expression of TLR 1, 2 3, and 4.
Limitations, reasons for caution: The relative small sample size of this study precludes the analysis of the relationship between conception and pregnancy outcome.
Wider implications of the findings: It appears that adverse effect of CE on reproduction is mediated via the IFN-γ pathway. Further study should be conducted to explore how alteration of IFN-γ leads to implantation failure with the
regulation of TLRs.
All Author(s) ListLiu Y, Man GCW, Chen X, Wu F, Cheung WC, Zhao Y, Huang J, Wang CC, Li TC
Name of ConferenceThe 34th Annual Meeting of the European Society of Human Reproduction and Embryology (ESHRE)
Start Date of Conference01/07/2018
End Date of Conference04/07/2018
Place of ConferenceBarcelona
Country/Region of ConferenceSpain
Proceedings TitleHuman Reproduction
Volume Number33
Issue NumberSupp 1
PublisherOxford University Press
Pages265 - 265
LanguagesEnglish-United Kingdom

Last updated on 2021-21-09 at 00:11