Subclinical endometritis in beef cattle in early and late postpartum: Cytology, bacteriology, haptoglobin and test strip efficiency to evaluate the evolution of the disease

General and comparative aspects of endometritis in domestic species: A review

Endometritis is a leading cause of sub- and infertility in domestic animal species. The healthy uterus is colonized by commensal bacteria, viruses and yeast/fungi that represent the nonpathogenic microbiota. A shift in the number or type of organisms accompanied by immune dysfunction, however, may trigger uterine infection and inflammation. Metritis is associated with inflammation of all uterine layers (endometrium, myometrium and perimetrium), whereas endometritis is a more superficial inflammation involving solely the endometrium. Endometritis generally occurs at two time points in domestic animal species, postpartum and postmating. Postpartum endometritis may chronically persist, either as a low-grade disease that often manifests as a vaginal discharge but not a systemic illness (in some species termed clinical endometritis) or sometimes subclinical where features are only detected by endometrial sampling. Contamination of the uterus at the time of mating occurs by direct deposition of semen (ejaculated or artificially inseminated) into the uterus. Improper drainage of the ejaculatory fluid or an inadequate immune response may result in persistent mating-induced endometritis. Both postpartum and postmating endometritis interferes with fertility by creating a suboptimal environment for embryo development and placentation, and chronic endometritis may have an impact on sperm survival and fertilization ability. In the postpartum animal, there may also be changes in milk production and maternal behaviour, which can affect offspring health and survival. Preventive strategies for endometritis largely depend on monitoring their known risk factors, which are sometimes specific with regard to the species. Effective, nonantibiotic therapy for endometritis is not available to date. Overall, extensive research has been performed in cattle and horses to unravel key aspects of endometritis, but in sows and bitches, the available literature is scant. Thus, the need and opportunity to investigate the condition vary considerably among domestic species and necessitate their comparative assessment. This article reviews general and comparative aspects of the diagnosis and classification, pathogenesis, preventive strategies and therapeutics of endometritis in domestic species with a specific focus on cows, mares, sows and bitches.

Clinical Trial on the Usefulness of On-Site Evaluation of Canine Fetal Fluids by Reagent Test Strip in Puppies at Elective Caesarean Section

Simple Summary

In veterinary medicine, the availability of an easy tool for the immediate evaluation of biological fluids’ composition on site is desirable and beneficial as a first-line diagnostic instrument in many instances and in several animal species. The aim of the present study was to assess the usefulness of reagent urinary test strips marketed for urines for the on-field evaluation of fetal fluids’ composition in newborn dogs at elective caesarean section. From surviving newborns, a collection of 113 amniotic and 107 allantoic samples was performed, and 8 amniotic and allantoic fluids were collected from non-surviving newborns. All the fetal fluids were assessed by urinary test strips within 5 min from collection. Significant differences were found for both types of fluid between surviving and non-surviving puppies, and between medium/large and small-sized puppies. Differences were also depicted between amniotic and allantoic fluids within the surviving group. These results seem to suggest that the on-site analysis of fetal fluids’ composition by reagent test strips could represent a first-line tool for the evaluation of puppies and for the quick identification of puppies requiring special monitoring and assistance.

Abstract

The reagent urinary test strips (TS) marketed for urines represent the first-line diagnostic tool in many instances. Therefore, the aim of the study was to assess the usefulness of TS for the on-field evaluation of fetal fluids’ composition in newborn dogs at elective caesarean section. Of a total of 137 puppies born at term, 127 survived and 10 did not survive. One hundred and thirteen amniotic and 107 allantoic samples from surviving newborns were collected, and 8 amniotic and allantoic fluids were collected from the non-surviving newborns and assessed by strips. Significantly lower amounts of amniotic glucose and higher amounts of amniotic and allantoic nitrites, amniotic protein, allantoic urobilinogen, and amniotic bilirubin concentrations were found in non-surviving when compared to surviving newborns. In the surviving ones, higher specific gravity and bilirubin concentrations, and lower pH, were found in allantoic than in amniotic fluids. Higher amniotic and allantoic glucose concentrations, higher amniotic and allantoic pH, and lower amniotic and allantoic protein concentrations were found in medium/large- than in small-sized puppies. The TS allowed the quick evaluation of fetal fluids in puppies at birth. The differences between surviving and non-surviving puppies seem to suggest that the on-site analysis of fetal fluids’ composition by TS could represent a first-line diagnostic tool in the field of canine neonatology, allowing the quick recognition of puppies needing assistance as a complementary tool for clinical evaluation.

Evaluation of Reproductive Tract Cytokines in Post-partum Beef Cows Relating to Reproductive Microbiota and Fertility Outcomes

The activity of the immune system in the reproductive tract has been proven to be crucial in the response to uterine diseases, normal reproductive functions, and tolerance to the allogeneic fetus during pregnancy. The objectives of the current study were to (1) evaluate uterine and vaginal cytokine concentrations in postpartum cows undergoing estrus synchronization followed by timed artificial insemination (TAI) and (2) correlate bacterial communities with cytokine concentrations. Postpartum Angus cows (n = 20) were subjected to a 7-Day Co-Synch protocol with pre-synchronization beginning 21 days prior (d −21) to TAI (d 0). Uterine and vaginal flushes were collected on d −21 and −2. Pregnancy was determined by transrectal ultrasound on d 30. Cytokines include interleukin (IL)-1b, IL-6, IL-10, transforming growth factor beta (TGF-β), and immunoglobin A (IgA) and concentrations were determined by commercial ELISA kits. No differences by day or pregnancy status in cytokine concentrations were detected in vaginal samples. No differences by day or pregnancy status in IgA, IL-10, or IL-1b concentrations were detected in uterine samples. Overall TGF-β concentrations in the uterus were greater in resulting pregnant than non-pregnant cows (44.0 ± 13.4 pg/mL vs. 14.7 ± 4.9 pg/mL; P = 0.047). Uterine TGF-β was correlated with the relative abundance of genera Treponema (r = −0.668; P = 0.049) in resulting non-pregnant cows on d −21 and with the relative abundance of genera Ureaplasma (r = 0.901; P = 0.0004) in resulting pregnant cows on d −2. In resulting pregnant animals, a tendency for a strong correlation was detected between d −2 progesterone concentrations and uterine TGF-β concentrations (r = 0.591, P = 0.07). Overall IL-6 concentrations in the uterus were greater in resulting non-pregnant than pregnant cows (198.7 ± 21.8 pg/mL vs. 144.3 ± 16.1 pg/mL; P = 0.045). A correlation was also detected between uterine IL-6 concentrations and the relative abundance of genera Butyrivibrio (r = 0.742; P = 0.022) in resulting non-pregnant cows on d −21. These results suggest possible relationships between different bacterial communities and cytokine concentrations within the uterus of beef cattle prior to TAI that may ultimately affect fertility outcomes.

MicroRNAome: Potential and Veritable Immunomolecular Therapeutic and Diagnostic Baseline for Lingering Bovine Endometritis

The bovine endometrium is a natural pathogen invasion barrier of the uterine tissues' endometrial epithelial cells that can resist foreign pathogen invasion by controlling the inflammatory immune response. Some pathogens suppress the innate immune system of the endometrium, leading to prolonged systemic inflammatory response through the blood circulation or cellular degradation resulting in bovine endometritis by bacterial endotoxins. The microRNA (miRNA) typically involves gene expression in multicellular organisms in post-transcription regulation by affecting both the stability and the translation of messenger RNA. Accumulated evidence suggests that miRNAs are important regulators of genes in several cellular processes. They are a class of endogenous non-coding RNAs, which play pivotal roles in the inflammatory response of reproductive diseases. Studies confirmed that miRNAs play a key regulatory role in various inflammatory diseases by mediating the molecular mechanism of inflammatory cytokines via signal pathways. It implicates some miRNAs in the occurrence of bovine endometritis, resorting to regulating the activities of some inflammatory cytokines, chemokine, differentially expressed genes, and protein through modulating of specific cellular signal pathways functions. This review dwells on improving the knowledge of the role of miRNAs involvement in inflammatory response as to early diagnosis, control, and prevention of bovine endometritis and consequently enlighten on the molecular improvement of the genes coded by various differentially expressed miRNA through the need to adopt recent genetic technologies and the development of new pharmaceutical preparations.

Diagnostic evaluation of subclinical endometritis in dromedary camels

The objective of the present study was to evaluate the efficacy of various diagnostic methods and to estimate the prevalence of bacterial pathogens associated with subclinical endometritis (SCE) in dromedary camels. During two consecutive breeding seasons, a total of 2122 infertile female dromedaries were assigned to this study and suspected cases of SCE were identified using the established criteria which included failure to conceive after three or more consecutive matings with a fertile male, a clinically healthy genital system, no observable vaginal discharge, and normal sexual behavior. Manual vaginal examination, Metricheck, bacteriological examination using endometrial swabbing, and hemogram assessments were conducted and there were comparisons of results to when there was cytological examination using the Cytobrush technique as the gold standard. The threshold value for positive cases of SCE was set at ≥ 5% polymorphnuclear cells in the cytological samples. Subclinical endometritis was diagnosed in 211 9.94 %) of the total infertility cases. Endometrial swabbing was a more sensitive and specific technique for diagnoses compared with the other methods. Bacillus sp., Staphylococcus sp., and Candida albicans were the most commonly isolated microorganisms. Hemogram testing and rectal and ultrasonographic examinations were not effective for the diagnosis of SCE. It was concluded that, compared with other diagnostic tests, bacteriological examination is more sensitive and specific for the detection of SCE in dromedaries.

Effects of in-feed clinoptilolite treatment on serum metabolic and antioxidative biomarkers and acute phase response in dairy cows during pregnancy and early lactation

The objective of this study was to evaluate the effects of in-feed clinoptilolite (CPL) on serum metabolic and antioxidative biomarkers, acute phase proteins and reproductive performance in cows during pregnancy and lactation. A total of 78 Holstein-Friesian cows were randomly assigned into two groups: the treatment group, cows fed CPL (n = 38) which received 50 g of powdered CPL twice a day from day 180 before parturition to day 60 postpartum; and the control group (n = 40). Blood samples were taken on days 180, 90, 60, 30 and 10 before parturition, on day of calving and on days 5, 12, 19, 26, 33, 40 and 60 postpartum, and were analysed for metabolic biomarkers: glucose, triglycerides, total cholesterol, high density lipoprotein cholesterol, non-esterified fatty acids, beta-hydroxybutyrate (BHB), antioxidative biomarkers and acute phase proteins: paraoxonase-1 (PON1), apolipoprotein A-I, haptoglobin (Hp) and serum amyloid A (SAA). CPL supplementation increased concentration of glucose and significantly decreased (P < .05) level of BHB during puerperium. The SAA concentration in CPL-fed cows was significantly decreased (P < .05) on days 33, 40 and 60 postpartum as well as Hp concentration on days 0 and 12 postpartum. The results of this study suggest that the CPL-fed cows may have improved metabolic status due to the tendency of greater glucose levels and decreased BHB values during early lactation. In addition, acute phase response was lower (P < .05) in CPL-fed cows. Such an outcome might be attributed to the effect of dietary CPL on intensity and severity of the negative energy balance and inflammatory response in dairy cows.

Structural uterine changes in postpartum endometritis in cows

AIM

The purpose of this work was to study the dynamics of structural manifestations of acute cases of postpartum endometritis in cows.

MATERIALS AND METHODS

The light and electron microscopy methods were used when studying structural changes in the endometrium in case of postpartum endometritis in seven cows. Sections of endometrial specimens for light microscopy, 5-7 µm thick, were stained with hematoxylin and eosin and also by Van Gieson's. For electron microscopy, semi-thin sections were stained with Azur-2 in combination with basic fuchsin, as well as contrasting by lead citrate and uranyl acetate.

RESULTS

As a result of the study, we have established the following: Necrobiosis of the epithelial layer of the mucosa, cellular infiltration with shaped elements of blood in the functional layer, swelling of the cells of the uterine gland, and single microbial cells on the surface of the mucosa. We have noted edema of the stroma of the functional layer of the endometrium, swelling of the epithelial layer of the endometrial mucosa, and swelling of fibroblastic and lymphoid cells. Ultrastructural changes in endometrial cells in case of acute postpartum endometritis in cows are accompanied by the destruction of microvilli on the apical surface of the epithelium, an abundance of coccal microflora on the surface of the epithelium, necrobiosis of epithelial cells, and partial edema of the nucleus, and cytoplasm of the histiocyte.

CONCLUSION

We had established that acute purulent-catarrhal dystrophic processes were observed in the structural organization of the endometrium. In the depth of catarrhal mucus on the surface of the endometrium, there was an abundance of bacterial flora, with diplococci being prevalent. In ultrastructural organization of the endometrium, we observed deep dystrophic and necrobiotic processes in the parenchyma and endometrial stroma, as well as exudative processes with a change in the integrity of the microcirculatory bed. Thus, to prevent an inflammatory process from turning into a latent form, it is necessary to detect acute postpartum endometritis promptly using diagnostic methods taking into account the obtained parameters of the dynamics of structural changes in the uterine tissues.

Endometrial expression of the acute phase molecule SAA is more significant than HP in reflecting the severity of endometritis

This study investigated the correlation between endometrial local expressions of serum amyloid A (SAA) and haptoglobin (Hp) and severity of endometritis in 20 Chinese Holstein dairy cows at 40-60 days postpertum, aged 3-6, and 2-5 parities. Endometrial biopsies were collected and categorized into normal, mild endometritis, and severe endometritis based on clinical signs and histopathology. The protein and mRNA expression of SAA and Hp in endometrial tissue were measured using western blot and real-time PCR, respectively. Furthermore, bovine endometrial epithelial cells were isolated and cultured in vitro. The protein and mRNA expression of SAA and Hp were also determined in the cells treated with increasing concentrations of lipopolysaccharide (LPS; 0, 1, 5, 10 μg/ml). The results showed that both of protein and mRNA of SAA was increased in endometritis or in LPS-stimulated cells, and the increases were positively correlated with severity of endometritis in vivo or LPS stimulation strength in vitro. Meanwhile, protein expression of Hp were also increased in endometritis or in LPS-stimulated cells, but the increases were negatively correlative with severity of inflammation as well as mRNA expression of Hp in vivo or in vitro. Therefore, our results suggest that endometrial local expression of SAA is more significant than Hp as a potential biomarker to assess severity of endometritis in cows.

Uterine inflammation and fertility of beef cows subjected to timed AI at different days postpartum

The aim of this study was to evaluate the uterine health and fertility of postpartum beef cows subjected to timed AI (TAI) protocols at different days from calving. Lactating Nelore cows (Bos indicus; n = 244) were used in this study. The TAI protocols were initiated between 20 and 60 days postpartum (DPP). Cows were subjected to an estradiol-progesterone based TAI protocol. The cows were divided into three groups according to the days postpartum at the time the hormonal treatment was initiated: 1) Early (n = 64), cows between 20 and 30 DPP; 2) Middle (n = 115), cows between 31 and 45 DPP; and 3) Late (n = 65), cows between 46 and 60 DPP. At Day 0 of the protocol, endometrial cytobrush samples were collected. Slides for polymorphonuclear (PMN) cell counting were prepared and cytobrush was used for RNA extraction and analysis of relative abundance of il1, il6, il8, and tnf mRNA. Cows from the Early group had less (P < 0.05) pregnancies per AI (P/AI) than cows from Middle and Late groups; 29.7% (19/64), 45.2% (52/115), and 52.31% (34/65), respectively. Accordingly, the Early group had a greater (P < 0.05) proportion of PMN cells in the uterus than Middle and Late groups; 9.0%, 3.8%, and 2.2%, respectively. Relative abundances of il1 and il8 mRNA were greater (P < 0.05) in the Early group than Middle and Late groups. These results indicate that beef cows subjected to TAI protocols early postpartum (< 30 DPP) are less likely to become pregnant, which is associated with increased inflammation and relative abundance of mRNA for the proinflammatory cytokines il1 and il8.

Comparison of cow-side diagnostic techniques for subclinical endometritis in dairy cows

A limited number of cow-side diagnostic techniques exist for the diagnosis of subclinical endometritis (SCE) in dairy cattle. The objectives of this study were to compare results of endometrial cytology from samples collected by cytobrush (CB) and low-volume lavage (LVL) and to assess leukocyte esterase (LE) test strips and Brix refractometry as surrogate cow-side tests for SCE. Two samples were consecutively collected from 248 Holstein cows between 29 and 35 days postpartum, using CB and LVL techniques. Each sample was analyzed using cytology with a cut-point of ≥5% polymorphonuclear (PMN) cells, LE strips using cut-points of ≥1 and ≥ 2, and a Brix refractometer. Each diagnostic technique was compared intra-sample using the respective cytology as a gold standard and inter-sample using CB samples as the referent. The concordance correlation coefficient (CCC, ρ_c) for PMN% between CB and LVL was ρ_c = 0.59 [95% confidence interval (CI): 0.50 to 0.67] and the Kappa (κ) for agreement was κ = 0.35 [sensitivity (Se) = 0.88, specificity (Sp) = 0.45]. The optimal cut-point of LE ≥ 2 resulted in moderate agreement between CB and LVL samples, κ = 0.56 (Se = 0.89, Sp = 0.65). Agreement between LE and cytology using CB (κ = 0.49; Se = 0.89, Sp = 0.57) and LVL (κ = 0.44; Se = 0.77, Sp = 0.67) were similar. The correlation between Brix values from CB and LVL was ρ_c = 0.12 (CI -0.01 to 0.26). The correlation between CB cytology and Brix was ρ_c = 0.33 (CI 0.20 to 0.45) but ρ_c = -0.07 (CI -0.21 to 0.06) between LVL cytology and Brix. While LE strips with a cut-point of LE ≥ 2 had moderate agreement with cytology, Brix refractometry had poor performance for the diagnosis of SCE. Samples taken by CB and LVL produced comparable cow-side diagnostic results and either is a viable method for the diagnosis of SCE.