Mast cells as inducers of chronic endometritis

Abstract

Objective. To present the results of mapping the spatial phenotype of mast cell (MC) distribution in the endometrium and to identify patterns of their interactions with other immunocompetent cells in endometritis of varying severity in women with recurrent pregnancy loss (RPL) and abnormal uterine bleeding (AUB). Patients and methods. In this prospective observational comparative study, a cohort of reproductive-aged women (n = 53) with a history of AUB and RPL were analyzed. All patients had a pathology-confirmed diagnosis of chronic endometritis. The morphological control group consisted of 10 women with a normal menstrual cycle and preserved reproductive potential, and with morphologically unaltered endometrium according to the results of diagnostic Pipelle biopsy performed prior to planned surgery for uterine fibroids. To map the spatial phenotype of MC distribution in the endometrium and to identify patterns of their interactions with other immunocompetent cells in endometritis of varying severity, multiplex immunohistochemistry and bioinformatic analysis technologies were employed. Results. A correlation between MC content in the endometrium and the severity of chronic inflammation was demonstrated. Spatial patterns of MC accumulation within endometrial loci were identified, along with their profiling and mapping in chronic inflammation of varying severity. The role of juxtacrine and paracrine effects of tryptase on cytotoxic T lymphocytes and monocytes was observed. Key words: mast cells, tryptase, endometritis, spatial phenotyping, mapping