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DOI: 10.15653/TPG-150581
Relationship between uterine biopsy score, endometrial infection and inflammation in the mare
Zusammenhang zwischen dem Endometriumbiopsie-Score, der endometrialen Infektion und der Entzündungsreaktion bei der StutePublication History
Received: 24 July 2015
Accepted after major revision: 30 January 2015
Publication Date:
20 December 2017 (online)
Summary
Objective: Endometrial biopsy score is an accepted marker of uterine health and predicted fertility, and it has been suggested that endometrial alternations are correlated with susceptibility to persistent infectious endometritis. The objective of this study was to investigate associations of endometrial biopsy score with: 1) presence of polymorphonuclear cells (PMNs) in the epithelium and stratum compactum in histopathology; 2) presence of PMNs in cytology and 3) presence of infection in microbiology. Materials and methods: The material for examination was collected from 69 mares suspected for subclinical endometritis (bred three or more times unsuccessfully in the same breeding season) and from 15 maiden mares. Samples were collected by endometrial biopsy and cytobrush technique. Results: Endometrial alterations (biopsy score IIA, IIB, III) were found in 64 of 82 mares (78%). There was an increase in PMN occurrence for grades IIA, IIB and III. When comparing grades and PMNs infiltration, we observed statistically significant differences between grades I and IIA (p = 0.222) and grades I and IIB (p = 0.042) in samples collected by endometrial biopsy. Statistically significant differences were found in microbiological examination (biopsy p = 0.036; cytobrush p = 0.189), cytological examination (biopsy p = 0.040; cytobrush p = 0.079) and PMN infiltration (p = 0.042) between mares with biopsy scores I and IIB. Furthermore, the highest percentage of infected mares was in grade IIA and IIB, and we found statistically significant differences between grades I and IIA (p = 0.043), and grades I and IIB (p = 0.036) in biopsy samples. We observed a tendency to higher prevalence of endometrial infection in mares with biopsy score IIA, IIB and III than with biopsy score I in samples collected using cytobrush technique. However, there were no statistical significant differences. Conclusion: Degenerative endometrial changes can predispose to uterine infection and inflammation. Our study shows that mares with endometrial score I are less predisposed to infection than mares with category IIA, IIB and III. Endometrial biopsy is a reliable diagnostic tool.
Zusammenfassung
Gegenstand und Ziel: Der Endometriumbiopsie-Score (EBS) ist ein eta - blierter Parameter zur Beurteilung der Gebärmuttergesundheit und Fertilitätsprognose. Es wird davon ausgegangen, dass Endometriumveränderungen mit der Empfänglichkeit für persistierende chronische Entzündungen korrelieren. Die Studie untersuchte den Zusammenhang zwischen dem EBS und 1) der histopathologisch ermittelten Häufigkeit polymorphkerniger Zellen (PMNs) im Epithel und Stratum compactum; 2) der zytologisch bestimmten PMN-Häufigkeit und 3) einer mikrobiologisch festgestellten uterinen Infektion. Material und Methoden: Die mittels Endometriumbiopsie und Cytobrush-Technik entnommenen Proben stammten von 69 Stuten mit Verdacht auf subklinische Endometritis (drei oder mehr erfolglose Belegungen in der laufenden Decksaison) und von 15 Maidenstuten. Ergebnisse: Endo metriumveränderungen (EBS IIA, IIB, III) wurden bei 64 von 82 Stuten (78%) festgestellt. Die Häufigkeit von PMNs nahm bei Stuten der Ka tegorien IIA, IIB und III zu. Beim Vergleich der Bioptate von Stuten unterschiedlicher Kategorien lagen statistisch signifikante Unterschiede zwischen I und IIA (p = 0,222) sowie I und IIB (p = 0,042) vor. Es bestanden statistisch signifikante Unterschiede bei der mikrobiologi schen Untersuchung (Biopsie p = 0,036; Cytobrush p = 0,189), zytolo gischen Untersuchung (Biopsie p = 0,040; Cytobrush p = 0,079) und PMN-Infiltration (p = 0,042) zwischen Stuten der Kategorien I und IIB. Der höchste Prozentsatz infizierter Stuten fand sich in den Kategorien IIA und IIB und es ergaben sich statistisch signifikante Unterschiede zwischen den Stuten der Kategorie I und IIA (p = 0,043) sowie I und IIB (p = 0,036) bei den mittels Biopsie gewonnenen Proben. Eine Tendenz zu höherer Prävalenz einer uterinen Infektion zeigte sich bei den mittels Cytobrush gewonnenen Proben zwischen Stuten der Ka - te gorien IIA, IIB und III im Vergleich zu Stuten der Kategorie I. Schlussfolgerung: Degenerative Endometriumveränderungen können für uterine Infektionen und Entzündungen prädisponieren. Die Studie verdeutlicht, dass Stuten mit EBS I weniger empfänglich für eine Infektion sind als Stuten der Kategorien IIA, IIB und III. Die Endometriumbiopsie ist eine zuverlässige diagnostische Methode.
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