Enfermedad Inflamatoria Pélvica

Limitations of the criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease research.

Vicetti Miguel RD¹, Chivukula M, Krishnamurti U, Amortegui AJ, Kant JA, Sweet RL, Wiesenfeld HC, Phillips JM, Cherpes TL.

¹University of Pittsburgh School of Medicine, Department of Pediatrics, PA 15224, USA.

 

Abstract

While endometrial neutrophils and plasma cells are criteria used to diagnose histologic endometritis in epidemiologic pelvic inflammatory disease (PID) research, plasma cell misidentification and nonspecificity may limit the accuracy of these criteria. Herein, we examined: (1) the identification of endometrial plasma cells with conventional methyl green pyronin-based methodology versus plasma cell-specific (CD138) immunostaining, (2) the prevalence of endometrial plasma cells among women at low risk for PID, and (3) endometrial leukocyte subpopulations among women diagnosed with acute or chronic histologic endometritis by conventional criteria. We observed an absence of CD138+ cells in 25% of endometrial biopsies in which plasma cells had been identified by conventional methodology, while additional immunohistochemical analyses revealed indistinguishable inflammatory infiltrates among women diagnosed with acute or chronic endometritis by conventional criteria. Among women considered at lower risk for PID development, flow cytometric analyses detected plasma cells in 30% of endometrial biopsy specimens, suggesting that these cells, even when accurately identified, only nonspecifically identify upper genital tract inflammatory processes. Combined, our findings underscore the limitations of the criteria used to diagnose histologic endometritis in PID-related research and suggest that satisfactory understanding of PID pathogenesis, treatment, and prevention is hindered by continued use of these criteria.

Copyright © 2011 Elsevier GmbH. All rights reserved.

Pathol Res Pract. 2011 Nov 15;207(11):680-5. doi: 10.1016/j.prp.2011.08.007. Epub 2011 Oct 13.

http://www.sciencedirect.com/science/article/pii/S0344033811002044

Md. Rodolfo Vicetti. Ex-miembro del GII.

Chlamydia trachomatis e Inmunidad

Chlamydia trachomatis infection control programs: lessons learned and implications for vaccine development.

Chavez JM¹, Vicetti Miguel RD, Cherpes TL.

¹Department of Pediatrics, University of Pittsburgh School of Medicine, Rangos Research Center, Room 9123, 4401 Penn Avenue, Pittsburgh, PA 15224, USA.

 

Abstract

Chlamydia trachomatis control efforts that enhance detection and treatment of infected women may paradoxically increase susceptibility of the population to infection. Conversely, these surveillance programs lower incidences of adverse sequelae elicited by genital tract infection (e.g., pelvic inflammatory disease and ectopic pregnancy), suggesting enhanced identification and eradication of C. trachomatis simultaneously reduces pathogen-induced upper genital tract damage and abrogates formation of protective immune responses. In this paper, we detail findings from C. trachomatis infection control programs that increase our understanding of chlamydial immunoepidemiology and discuss their implications for prophylactic vaccine design.

Infect Dis Obstet Gynecol. 2011;2011:754060. doi: 10.1155/2011/754060. Epub 2011 Nov 14.

http://www.hindawi.com/journals/idog/2011/754060/

Md. Rodolfo Vicetti. Ex-miembro del GII.