Reproductive Medicine Center, The Affiliated Hospital of Youjiang Medical University for Nationalities, Baise, China.
Reproductive Medicine Center, The First Affiliated Hospital of Guangxi Medical University, Nanning, China.
J Obstet Gynaecol Res. 2023 Jan;49(1):243-252. doi: 10.1111/jog.15451. Epub 2022 Oct 24.
The chronic endometritis (CE) prevalence in people experiencing infertility is 2.8-56.8%, pregnancy rates in patients with infertility increase after hysterosalpingography with oil-based contrast, but the effect and mechanism are not clear. Here, we analyzed the effects of intrauterine ethiodized poppyseed oil (EPO) bathing on a rat model of CE and the possible underlying mechanism.
CE rats were induced by lipopolysaccharide (LPS) exposure, and rats were subjected to intrauterine bathing with EPO or phosphate-buffered saline (PBS) after model verification. Serum and uterus levels of IFN-γ, IL-4, TNF-α, and IL-1β were detected by ELISA kit, and the number of CD138 and CD68 cells and uterine IFN-γ, IL-4, TNF-α, IL-1β, and NF-κB P65 expression were detected by immunohistochemistry after bathing.
LPS exposure induced the typical CE phenotype with CD138 phagocyte infiltration of the endometrial stroma. Compared with PBS bathing, bathing with EPO in CE rats showed decreases in the CD138 and CD68 cells populations and significant decreases in serum and uterine IFN-γ levels, moreover, uterine IL-4 levels were slightly higher, and the IFN-γ/IL-4(Th1/Th2-type cytokine ratio) in the uterus was significantly lower. Local IFN-γ, TNF-α, and NF-κB P65 expression in the endometrium was significantly downregulated, while IL-4 expression was upregulated.
Intrauterine oil-based contrast bathing significantly alleviated local inflammation in the rat CE model by downregulating NF-κB P65 expression, reducing IFN-γ (Th1), increasing IL-4 levels (Th2) in the endometrium, and regulating the Th1/Th2-type cytokine trends toward Th2.
不孕人群中慢性子宫内膜炎(CE)的患病率为 2.8-56.8%,经子宫输卵管造影(HSG)加油基造影剂后,不孕患者的妊娠率增加,但作用机制尚不清楚。本研究分析了宫腔内碘化罂粟籽油(EPO)浴对 CE 大鼠模型的影响及其可能的作用机制。
通过脂多糖(LPS)暴露诱导 CE 大鼠模型,在模型验证后,用 EPO 或磷酸盐缓冲盐水(PBS)进行宫腔内浴。采用 ELISA 试剂盒检测血清和子宫组织中 IFN-γ、IL-4、TNF-α 和 IL-1β 的水平,免疫组化法检测 CD138 和 CD68 细胞数及子宫组织中 IFN-γ、IL-4、TNF-α、IL-1β 和 NF-κB P65 的表达。
LPS 暴露诱导子宫内膜基质中 CD138 吞噬细胞浸润,出现典型的 CE 表型。与 PBS 浴相比,CE 大鼠宫腔内 EPO 浴后 CD138 和 CD68 细胞数减少,血清和子宫组织 IFN-γ 水平明显降低,IL-4 水平略有升高,子宫组织中 IFN-γ/IL-4(Th1/Th2 型细胞因子比值)明显降低。子宫内膜局部 IFN-γ、TNF-α 和 NF-κB P65 表达明显下调,IL-4 表达上调。
宫腔内油基造影剂浴通过下调 NF-κB P65 表达,降低子宫内膜 IFN-γ(Th1)水平,增加 IL-4 水平(Th2),调节 Th1/Th2 型细胞因子向 Th2 趋势,显著缓解大鼠 CE 模型的局部炎症。