Kogan E A, Demura T A, Vodianoĭ V Ia, Shurshalina A V
Arkh Patol. 2012 May-Jun;74(3):15-7.
The endometrial receptivity is a complex of structure-functional characteristics of endometrium with clear temporal and spatial constants, conditioning the ability of endometrium to the implantation. The aim of our research was a studying of morphological and molecular aspects of the endometrial receptivity disorders at chronic endometritis. The basic studied group included cases of chronic endometritis (CE) with unknown etiology (30 patients) and with CE under autoimmune thyroiditis (26 patients with presence of antithyroid antibodies--ATA). All patients had different disorders of reproductive function; some of them were infertile. More over 73% of all studied patients were of the 26-40 ages old. The control group was presented by endometrium of healthy surrogate mothers (10 cases). The research was done on the Pipelle biopsies of endometrium, which was taken in the secretory phase (the period of "implantation window"). For confirmation of the CE diagnosis, the endometrium of women with ATA was taken in the proliferative phase too. Morphological, immunohistochemical and statistical (nonparametric analysis of Mann-Whitney) methods were used. As the primary antibodies were used CD68, CD138, CD56, Ki-67, Apaf-1, LIE The structure analysis of pinopodes was carried out by stained paraffin slices (CytoViva Technologies Inc., Auburn, AL, USA) with using of the traditional and luminescent microscopy (the definition is over 100 nm). Structure and molecular changes of endometrium at CE include inflammatory infiltration, fibroblastic reactions and alteration of extracellular matrix; apoptosis of functional layer leading to its insusceptibility to the regulatory signals. Disorders of endometrial remodeling in the "implantation window" determine the result of implantation and can be reason of the infertility. The reduced receptivity at CE is characterized by decrease of mature pinopodes and low expression of LIF in the surface epithelium.
子宫内膜容受性是子宫内膜具有明确时间和空间常数的结构 - 功能特征的复合体，它决定了子宫内膜的着床能力。我们研究的目的是探讨慢性子宫内膜炎时子宫内膜容受性障碍的形态学和分子学方面。基础研究组包括病因不明的慢性子宫内膜炎（CE）病例（30例患者）以及自身免疫性甲状腺炎合并CE的病例（26例存在抗甲状腺抗体 - ATA的患者）。所有患者均有不同程度的生殖功能障碍；其中一些患者不孕。此外，所有研究患者中有73%年龄在26 - 40岁之间。对照组为健康代孕母亲的子宫内膜（10例）。研究采用在分泌期（“着床窗”期）采集的子宫内膜Pipelle活检样本。为确诊CE，ATA阳性女性的子宫内膜也在增殖期采集。采用了形态学、免疫组织化学和统计学（Mann - Whitney非参数分析）方法。使用的一抗有CD68、CD138、CD56、Ki - 67、Apaf - 1、LIE。通过美国阿拉巴马州奥本市CytoViva Technologies Inc.的石蜡切片染色，利用传统显微镜和荧光显微镜（分辨率超过100nm）对微绒毛进行结构分析。CE时子宫内膜的结构和分子变化包括炎症浸润、成纤维细胞反应和细胞外基质改变；功能层凋亡导致其对调节信号不敏感。“着床窗”期子宫内膜重塑障碍决定着床结果，可能是不孕的原因。CE时容受性降低的特征是成熟微绒毛减少以及表面上皮中LIF表达降低。
