Chronic endometritis: histological and immunohistochemical markers

• Published in: Journal of reproductive immunology 2023-09, Vol.159, p.104104, Article 104104
• Main Authors: Volkova, Larisa V., Omelchuk, Nadezhda N.
• Format: Article
• Language: English
• ISSN: 0165-0378; 1872-7603
• DOI: 10.1016/j.jri.2023.104104

Morphological verification of chronic endometritis (CE) is actual, frequency of CE in infertility varies within 2.8–56.8%, recurring miscarriages - 9.3–67.6%, in missed pregnancies - 57.8% (Goncharova E.A. et al., 2022). The aim of study – analysis of histological and immunohistochemical markers of CE. The analysis of publications in PubMed databases, E-library (2012-2023) was carried out, etiopatogenesis, markers of CE, diagnostical possibilities are considered. Histological changes in endometrium in CE include: infiltration by lymphocytes, plasma cells, granulocytes, lymphoid follicles in the functional layer, vascular changes, fibroblast-like elongated cells. Detection of plasma cells in endometrium with verification CD138-positive cells is gold standard for diagnosing of CE (Yingyu et al., 2018), but this approach is not is completely specific, there is no consensus on the number of plasma cells to confirm diagnosis. Potential markers of CE are discussed: CD68+macrophages, CD83+ mature dendritic cells, CD8+T cells, Foxp3+ regulatory T cells, CD56+ natural killer cells, CD16+ lymphocytes, activating marker HLA-DR(II) of lymphocytes, markers of fibrosis - matrix metalloproteinase 9, transforming growth factor-β, some others. Despite the different diagnostic approaches, many aspects of the pathogenesis of CE are not completely clear, significance of potential immunohistochemical markers is being specified, histopathological diagnostic standards do not fully meet modern requirements.We agree with the statement (Klimaszyk K. et al., 2023) that "it is of great importance to establish a consensus on the diagnostic criteria for chronic endometritis, to enhance international cooperation and create well-design multicenter studies” to study CE.