Dysregulated leukemia inhibitory factor and its receptor regulated signal transducers and activators of transcription 3 pathway: a possible cause for repeated implantation failure in women with dormant genital tuberculosis?

Abstract

Our findings suggest that endometrium of women with dormant GTB is associated with poor receptivity, as evidenced by reduced receptivity markers and aberrant LIF-STAT3 signaling. In vitro treatment of hESC with HSP65 also confirms compromised endometrial decidualization.

Identification of serum metabolic markers for diagnosis of women with dormant genital tuberculosis

“…PCR is a highly sensitive tool which has been successfully used for diagnosing GTB, even in the dormant form (Jindal 2006;Roy and Roy 2003;Bhanu et al 2005). Studies by Jindal et al (2012) and our group (Subramani et al 2016b) have shown that GTB-PCR can effectively diagnose dormant GTB in women when other conventional techniques fail to detect GTB in the endometrium. However, PCR is yet to be used reliably for the diagnosis of tuberculosis owing to the tendency of this technique to have false-positive or negative results.…”

“…Even dormant tubercle bacilli may cause functional damage to the endometrium and affect embryo implantation (Subramani et al 2016b). Due to paucibacillary nature of TB in the genital organs, conventional techniques including histology, acid-fast bacilli staining and culture tests show low-rate of positivity.…”

“…Further, upregulation of 1-methyl-histidine in serum of lung TB patients is known to cause muscle protein degradation (Zhou et al 2013). It is also suggested that dormant tubercle bacilli alters the endometrium at a molecular level (Subramani et al 2016b). We, therefore, presume that the increased level of 1-methyl-histidine in dormant GTB women is associated with alterations in the endometrium which is known to be responsible for implantation failure.…”

“…The incidence of GTB in developing societies such as India is reported to be as alarming as 18-19 % (Malik 2003;Das et al 2008). It is well recognized that the active form of GTB causes irreversible tubal and endometrial damage (Jindal et al 2010) and even the dormant (sub-clinical/latent) form is associated with repeated implantation failure (Bose 2011;Subramani et al 2016b).…”

“…Diagnosis of dormant GTB is a bigger challenge owing to the paucibacillary nature of the bacilli (Thangappah et al 2011). Polymerase chain reaction (PCR) has shown promising results for the diagnosis of dormant GTB with a considerable increase in sensitivity and specificity (Subramani et al 2016b;Thangappah et al 2011;Kulshrestha et al 2011). However, false positive or negative results are the important limitations associated with this technique (Shrivastava et al 2014).…”