Abstract:

Chronic endometritis (CE) is a chronic and persistent inflammation condition of endometrium, mainly caused by pathogen infection. It is potentially associated with infertility and poor reproductive outcomes. Although the pregnancy outcomes of some CE patients have been greatly improved after antibiotic treatment at present, the persistent CE is still a thorny problem in other patients, because the etiology of persistent CE is still unknown and the treatment effect is poor. More and more studies have suggested that the immune status of the endometrium in CE patients has changed, which is involved in the pathological process contributing to the reduced endometrial receptivity and adverse pregnancy outcomes. The changes of endometrial immune state in CE patients are mainly manifested as the number alterations of both innate immunocytes represented by uterine natural killer cells (uNK cells) and macrophages and adaptive immunocytes represented by B cells and CD4⁺T cells, the dysregulated proportion of CD4⁺T immune cell subsets and abnormal expression of cytokines and chemokines. In this artile, we reviewed the research progresses of endometrial immune state changes of CE, so as to gain further insights into the pathological characteristics and the internal mechanism that possibly affects the pregnancy outcomes of women with CE from the immune perspective.

Key words: Endometritis, Cellular immunity, Cytokines, Chemotactic factors, Pregnancy outcome