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2 . 2022

Effect of endometrial virome on local and general immune status

Abstract

The aim of the study to determine the effect of herpetic infection on the morphofunctional state of the endometrium and the overall immune status.

Design: observational, cohort, closed research.

Material and methods. The study included 88 patients of reproductive age with infertility, divided into two groups. Patients with chronic endometritis were group I (n=56), and patients without chronic endometritis with male infertility were group II (n=32). Group I patients, depending on the presence or absence of a herpesvirus infection clinic, are divided into Ia and Ib subgroups, respectively. Anamnesis data, complaints, and gynecological status were evaluated. A comprehensive microbiological study of the microbiome and viromе of the endometrium, a pipel biopsy of the endometrium with histological and immunohistochemical evaluation, a study of IgM and IgG in blood serum to herpesviruses, as well as a study of general immunity by flow cytometry were performed.

Results. There was no significant difference in the frequency of detection of positive PCR results for opportunistic flora, the degree of contamination in most patients did not exceed 104 GE/ml. Herpesviruses in group I were significantly more common (19.64%) than in group II (9.38%), p<0.05. In subgroup Ia, chronic endometritis without an autoimmune component was detected twice as often (66.67%) as autoimmune chronic endometritis (33.33%). Although the relationship of genital herpes with the occurrence of autoimmune inflammation has not been revealed, in all patients of subgroup Ia, inflammation was in the acute stage. The determination of specific IgG and IgM to CMV and HSV confirmed the high degree of infection of the patients. Changes in the immune status indicators indicate the presence of immune deficiency in both innate and adaptive cellular immunity.

Conclusion. Chronic endometritis in 19.64% of patients was caused by herpetic invasion, often without the accompaniment of a damaging microbial agent and was 1.8 times more common than autoimmune inflammation. The pathogenic effect of herpesviruses is confirmed by the weakening of cellular antiviral immunity (decrease in CD8+- and CD4+ T-lymphocytes), as well as depression of mucosal immunity (decrease in IgA) and a pronounced change in innate immunity in the form of a violation of phagocytosis processes.

Keywords:endometrial virome; herpesviruses; chronic endometritis; immune histochemical examination; immunodeficiency; infertility

Funding. The study had no sponsor support.

Conflict of interest. The authors declare no conflict of interest.

Contribution. Conceptualization - concept statement; statement and development of key goals and objectives; conducting research, data analysis and interpretation - Karakhalis L.Yu., Kononenko T.S; development of design and methodology - Karakhalis L.Yu., Kononenko T.S.; preparation and editing of the text - critical revision of the manuscript with the introduction of a valuable comment of intellectual content - Karakhalis L.Yu.; preparation and editing of the text - drafting the manuscript, participation in scientific design - Kononenko T.S; approval of the final version of the article - taking responsibility for all aspects of the work, the integrity of all parts of the article and its final version - Karakhalis L.Yu., Kononenko T.S.

For citation: Karakhalis L.Yu., Kononenko T.S. Effect of endometrial virome on local and general immune status. Akusherstvo i ginekologiya: novosti, mneniya, obuchenie [Obstetrics and Gynecology: News, Opinions, Training]. 2022; 10 (2): 6-13. DOI: https://doi.org/10.33029/2303-9698-2022-10-2-6-13 (in Russian)

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CHIEF EDITORS
CHIEF EDITOR
Sukhikh Gennadii Tikhonovich
Academician of the Russian Academy of Medical Sciences, V.I. Kulakov Obstetrics, Gynecology and Perinatology National Medical Research Center of Ministry of Healthсаre of the Russian Federation, Moscow
CHIEF EDITOR
Kurtser Mark Arkadievich
Academician of the Russian Academy of Sciences, MD, Professor, Head of the Obstetrics and Gynecology Subdepartment of the Pediatric Department, N.I. Pirogov Russian National Scientific Research Medical University, Ministry of Health of the Russian Federation
CHIEF EDITOR
Radzinsky Viktor Evseevich
Corresponding Member of the Russian Academy of Sciences, MD, Professor, Head of the Subdepartment of Obstetrics and Gynecology with a Course of Perinatology of the Medical Department in the Russian People?s Friendship University

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