Intrauterine Therapy with Platelet-Rich Plasma for Persistent Breeding-Induced Endometritis in Mares: A Review

Abstract

This review aims to emphasize the scientific focus on platelet therapies by presenting the results already obtained in mares susceptible to Persistent Breeding-Induced Endometritis (PBIE), as well as highlighting opportunities for further improvement. The recent publication demonstrating the absence of bacterial growth in susceptible mares treated with PRP underscores the potential of regenerative therapies to control infections without promoting the emergence of multidrug-resistant bacteria. Alternative therapies have gained prominence in the current public health context, with the World Health Organization listing antimicrobial resistance among the ten most significant global threats. Endometritis is the leading cause of subfertility in mares, and empirical antibiotic therapies are commonly used in the field due to market pressures related to the high financial value of embryos, along with logistical challenges in obtaining laboratory-dependent diagnostic results. Platelet-Rich Plasma (PRP) is an alternative therapy derived from whole blood plasma with a high concentration of platelets. Its anti-inflammatory, regenerative, and antimicrobial properties are particularly tested when traditional therapies fail to achieve the desired effect. In recent years, research on the use of PRP in equine reproduction has primarily focused on endometritis, with a particular emphasis on persistent breeding-induced endometritis (PBIE). However, there is a growing interest in other platelet derivatives, such as lyophilized platelet-rich plasma and platelet lysate, which offer practical field applications.