Endometrosis in Mares: Incidence of Histopathological Alterations

Flores, Juana M.; Rodrı́guez, Ana Valdeolmillos; Sánchez, José Miguel Perea; Gómez-Cuétara, Concepción; Ramiro, Freddy

doi:10.1111/j.1439-0531.1995.tb00606.x

Cited by 20 publications

(21 citation statements)

References 5 publications

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“…These mares reported increased PMN levels on endometrial cytology and intrauterine fluid retention 24 hours after AI when compared with mares with healthy endometrium. These findings are consistent with those of previous studies [2,6,12,49,50] that observed an association between an advanced degree of endometrial degeneration with uterine inflammation and fluid retention after insemination.…”

Section: Discussionsupporting

confidence: 93%

Inflammatory response in chronic degenerative endometritis mares treated with platelet-rich plasma

et al. 2016

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Degenerative changes of the endometrium are directly related to age and fertility in mares. Chronic degenerative endometritis (CDE) is correlated with uterine fluid retention and reduced ability to clear uterine inflammation. Recent research in the areas of equine surgery and sports medicine has shown that platelet-rich plasma (PRP) treatment acts as an immunomodulator of the inflammatory response. Therefore, the aim of this study was to determine if the uterine infusion of PRP could modulate the local inflammatory response and modify the intrauterine NO concentrations after artificial insemination (AI) in both normal mares and those with CDE. Thirteen mares with endometrium classified as grade III on the histology (mares with CDE) and eight mares with endometrial histological classification I or II-a normal mares were selected to investigate the effect of PRP therapy. The mares were inseminated with fresh semen in two consecutive cycles in a crossover study design. Thereby, each mare served as its own control and the treatment was performed with intrauterine PRP infusion four hours after AI. The percentage of neutrophils in uterine cytology (CIT, %), uterine fluid accumulation observed on ultrasonography (FLU, mm) and nitric oxide concentration of uterine fluid (NO, μM) were analyzed before and 24 hours after AI. The results reported that mares with CDE (CIT, 68.3 ± 3.27, FLU, 10.7 ± 1.61) have a higher (P < 0.05) intrauterine inflammatory response after AI than normal mares (CIT, 24.4 ± 3.56, FLU, 0), but NO concentrations did not differ (P > 0.05) between categories of mares. In treated cycles with PRP, the intrauterine inflammatory response decrease (P < 0.05) in CDE mares (CDE: CIT, 31.4 ± 6.48, FLU, 5.5 ± 1.28; normal mares: CIT, 13.5 ± 4.31, FLU, 0) when compared with nontreated cycle (CDE: CIT, 68.3 ± 3.27, FLU, 10.7 ± 1.61; NM: CIT, 24.4 ± 3.56, FLU, 0), but did not modify NO concentrations in uterine fluid. Thus, we can conclude that PRP was effective in modulating the exacerbated uterine inflammatory response to semen in mares with CDE but did not reduce NO concentrations in intrauterine fluid.

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Section: Discussionsupporting

confidence: 93%

Inflammatory response in chronic degenerative endometritis mares treated with platelet-rich plasma

et al. 2016

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“…The incidence and the degree of endometrosis in this study were higher than in the investigations of Schoon et al (1997b) and Schilling (2017) (see Table 3). These results confirm the assumption of endometrosis as an age-related disease (Doig et al 1981, Ricketts and Alonso 1991, Brinsko et al 1994, Schoon et al 1994, Flores et al 1995, Bracher et al 1997b, Schoon et al 1997b, Hoffmann 2006, Lehmann 2010, Aurich et al 2011) and moreover, the degree of endometrosis increases with ageing (Schoon et al 1995, Heilkenbrinker et al 1997, Schilling 2017. The occurrence of endometrosis in infertile ("nulliparous") female mules (Huth et al 2008, Jäger et al 2008) is further indicative of an age-related pathogenesis which is independent of parity.…”

Section: Discussionsupporting

confidence: 74%

Endometrial biopsies of old mares – What to expect?!

Kabisch¹,

Klose²,

Schoon³

2019

PHK

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Based on the ageing of the equine population, the number of old mares presented for breeding will also increase. However, aged mares frequently exhibit fertility problems. The objective of this study was a detailed histomorphological characterisation of endometrial biopsies of old mares to identify causes for their reduced fertility. For this purpose 819 endometrial biopsies of 814 old mares (minimum age: 20 years) submitted to the Institute of Pathology (Faculty of Veterinary Medicine, University of Leipzig) between 1993 and 2014 and the related anamnestic data were evaluated retrospectively. The study comprised a detailed histomorphological characterisation of endometrial alterations by haemalaun and eosin (H.E.) stain, the categorisation of the cases according to Kenney and Doig (1986) without or in consideration of the duration of barrenness and, for some randomly selected samples (n = 157), an assessment by Picro-Sirius Red stain for further investigation of degenerative angiopathies. Most of the cases were assigned to categories IIb and III (83 %) without consideration of the duration of barrenness or category III (68 %) in consideration of the duration of barrenness. The categorisation of the cases was based on the occurrence of endometrosis and, to a lesser extent, endometritis. In contrast, an endometrial atrophy or lymphatic lacunae were not observed in any sample. Nearly all biopsies (97 %) showed endometrosis which was mostly moderate. Endometritis was diagnosed in 49 % of all samples. The inflammation was predominantly mild and non-suppurative (subclinical). Histopathological findings which are not considered in the categorisation system of Kenney and Doig (1986) were frequently detected. This comprised degenerative lesions of blood vessels (angiosclerosis; 89 % of all samples; mostly moderate to severe), periglandular accentuated mononuclear inflammatory cell infiltrates (PAMC; 58 % of all samples; mostly mild), perivasculitis (43 % of all samples; mostly mild) and 16 % of all samples showed signs of endometrial maldifferentiation. The endometrium of old mares predominantly exhibited a mixture of endometrial alterations: mostly marked degenerative lesions (endometrosis and angiosclerosis), predominantly mild inflammatory processes (endometritis, PAMC and perivasculitis) and, to a lesser extent, functional disturbances. These findings are only partially considered in the evaluation scheme of Kenney and Doig (1986). However, histopathological findings which were left out of the categorisation scheme so far (e.g. angiosclerosis and other functional disorders than endometrial atrophy) also directly or at least indirectly influence the fertility of a mare. Therefore, these findings as well as the age of the mare have also to be evaluated for a precise prediction of the reproductive potential of the old mare. In any case the endometrial biopsy can be helpful for the owner or the veterinarian to decide whether breeding an old mare is an acceptable risk, especially in mares whose reproduction potential is c...

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“…On the other hand, the association between lymphocytic infiltrations and the presence of fibrosis has been described by different authors [8,9,20]. We used immunohistochemistry for the labeling of lymphocytes, by the cytoplasmic protein CD3 in the endometrial biopsies, this is not commonly found in literature dealing with mare endometrosis.…”

Section: Discussionmentioning

confidence: 99%

Complimentary Diagnostic Tools for Endometrosis in Biopsies of Mares with Clinical Subfertility

Rojas

Cabezas

Ramírez

et al. 2020

Acta Scientiae. Vet.

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Background: Endometrosis is a multifactorial disease and one of the main causes of infertility in mares, its etiology and pathogenesis are not completely understood. It is defined as peri glandular and/or stromal endometrial fibrosis with glandular alterations. Due to the few clinical symptoms, besides anamnesis and fertility data, endometrosis requires histological confirmation. The histo-morphology and immune histochemical characteristics of the endometrium vary among individuals according to the disease progression. The aim of this research was to combine histology with new immune and histochemical tools for a more precise detection of fibrotic changes of mares with endometrosis.Materials, Methods & Results: The endometrium of forty thoroughbred mares aged 5-18 years, that did not become pregnant during the last two breeding seasons in a Chilean commercial equine breeding center were biopsied. Samples were subjected to conventional histopathology with hematoxylin-eosin as well as to specific histological staining using specific techniques such as Alcian blue and Masson Fontana, aimed to ascertain what types of mucopolysaccharides were present in those samples. In order to have a deeper picture of the progression of the pathology, immune histochemical methods for the detection of vimentin, cytokeratin, progesterone receptor and lymphocyte marker CD3 were used. Finally in order to detect fibrillar collagen we used second harmonic generation (SHG) technique with detects fibrillar collagen without staining, due to intrinsic hyperpolarization ability of this type of collagen, which can be detected by atomic force microscopy. As a result of our research samples were categorized according to the scale of Keeney and Doig into categories I, IIa, IIb and III (45, 42, 7.5 and 5% respectively). These samples also were characterized by the methods listed earlier and a result we found specific staining in 15 samples coming from higher endometrial damage using Masson-Fontana, while acid staining indicative of acid mucopolysaccharides were detected in 97% of the samples. At immunostaining, we found cytokeratin and vimentin differentially expressed as a function of the degree of the lesions. Cytokeratin was detected in glands from healthy mares, but it was almost absent as the injury was increased. Vimentin in turn, was detected in 26 samples with different degree of intensity. In nine animals, vimentin expression was anomalous, and the marker was detected in fibrotic foci concentrically surrounding glands in biopsies of grade I and IIA only. Although progesterone receptor was detected, there was no correlation with endometrosis. Finally, the lymphocyte T specific CD3 marker was positive in 100% of cases analyzed in which moderate lymphocytic infiltration was found by hematoxylin-eosin; however no staining could be detected in mares with more advanced endometrosis. By combining immunofluorescence with the detection of second harmonic it was possible to detect in the same sample two proteins and collagen deposition at the same time, this had not been reported earlier for endometrosis and mares.Discussion: Our results suggest that the combination of the different methods mentioned is useful for validation and further characterization of the routine hematoxylin-eosin, and can be used as a complementary tool for the diagnosis. Of value, it was possible to combine immunofluorescence with SHG in a single sample in situ.

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Endometrosis in Mares: Incidence of Histopathological Alterations

Cited by 20 publications

References 5 publications

Inflammatory response in chronic degenerative endometritis mares treated with platelet-rich plasma

Inflammatory response in chronic degenerative endometritis mares treated with platelet-rich plasma

Endometrial biopsies of old mares – What to expect?!

Complimentary Diagnostic Tools for Endometrosis in Biopsies of Mares with Clinical Subfertility

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