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Žilovič D, Vaicekauskaitė I, Čiurlienė R, Sabaliauskaitė R, Jarmalaitė S. Uterine Cavity Lavage Mutation Analysis in Lithuanian Ovarian Cancer Patients. Cancers (Basel) 2023; 15. [PMID: 36765826 DOI: 10.3390/cancers15030868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2022] [Revised: 01/21/2023] [Accepted: 01/28/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Type II ovarian cancer (OC) is generally diagnosed at an advanced stage, translating into a poor survival rate. Current screening methods for OC have failed to demonstrate a reduction in mortality. The uterine lavage technique has been used to detect tumor-specific TP53 mutations from cells presumably shed from high-grade serous ovarian cancer (HGSOC). We aimed to pilot whether the detection of TP53 mutation in uterine cavity lavage can be used as a diagnostic method for HGSOC using an expanded gene panel. METHODS In this study 90, uterine lavage and 46 paired biopsy samples were analyzed using next-generation sequencing (NGS) targeting TP53 as well as five additional OC-related genes: BRCA1, BRCA2, PI3KCA, PTEN, and KRAS. RESULTS Uterine lavage was successfully applied to all patients, and 56 mutations were detected overall. TP53 mutations were detected in 27% (10/37) of cases of type HGSOC; BRCA1 and BRCA2 mutations were also frequent in this group (46%; 17/37). Overall concordance between tissue and liquid biopsy samples was 65.2%. CONCLUSION Uterine lavage TP53 mutations in combination with other biomarkers could be a useful tool for the detection of lowly invasive HGSOC.
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Omar H, Hambidge M, Firmanes B, Shabandri AM, Wilsher S. Bacteria isolated from equine uteri in The United Arab Emirates: A retrospective study. J Equine Vet Sci 2022; 115:104029. [PMID: 35659620 DOI: 10.1016/j.jevs.2022.104029] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/25/2022] [Accepted: 05/31/2022] [Indexed: 10/18/2022]
Abstract
The United Arab Emirates (UAE) presents a unique environment in which to breed horses with a non-physiological breeding season coupled with high temperatures and humidity for much of the year. This study aimed to describe bacterial isolates from the uteri of mares in the UAE and compare them to those reported elsewhere in the world. Bacterial antibiotic resistance was also analysed to give a starting point for future monitoring. A total of 2022 swabs taken over 5 breeding seasons from the endometrium (n = 1350) or from uterine lavages (n = 672) were submitted for microbiological culture and antibiotic sensitivity testing. At 48h post inoculation 616/2022 (30.5%) of cultures showed microbial growth from which 690 isolates were identified. Most positive plates (548/616; 89%) grew one isolate; 68 cultures had two (62/616; 10.1%) or three (6/616; 1%) isolates. The most frequently isolated bacteria were β-haemolytic Streptococcus (36.5%; 252/690), E. coli (10.6%; 73/690), P. aeruginosa (10.1%; 70/690), K. pneumoniae (8.8%; 61/690) and Aeromonas hydrophila (4.1%; 28/690). The lowest level of antibiotic susceptibility for all isolates was shown by trimethoprim-sulphonamide (36.4%; 198/544), with amikacin showing the highest (76.1%; 271/356). A significant decrease in susceptibility to doxycycline, enrofloxacin and erythromycin, but a significant increase for amoxicillin with clavulanic acid, was seen for β-haemolytic Streptococcus. Decreasing susceptibility of trimethoprim-sulphonamide between two time periods was seen for E. coli. Compared to other studies UAE-based mares had a high incidence of P. aeruginosa and K. pneumoniae isolates, whereas E. coli was represented far less frequently as an isolate.
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Affiliation(s)
- Hussein Omar
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Margaret Hambidge
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Bernadette Firmanes
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Abdul M Shabandri
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE
| | - Sandra Wilsher
- Sharjah Equine Hospital, Al Dhaid Road, Bridge No.6, Al Atain Area, Sharjah, UAE.
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Žilovič D, Čiurlienė R, Sabaliauskaitė R, Jarmalaitė S. Future Screening Prospects for Ovarian Cancer. Cancers (Basel) 2021; 13:3840. [PMID: 34359740 DOI: 10.3390/cancers13153840] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 06/19/2021] [Accepted: 07/26/2021] [Indexed: 12/20/2022] Open
Abstract
Simple Summary Ovarian cancer (OC) has the highest mortality rate of all gynecological cancers. It is usually diagnosed in late stages (FIGO III-IV), and therefore, overall survival is very poor. If diagnosed at the early stages, ovarian cancer has a 90% five-year survival rate. Liquid biopsy has a good potential to improve early ovarian cancer detection and is discussed in this review. Abstract Current diagnostic tools used in clinical practice such as transvaginal ultrasound, CA 125, and HE4 are not sensitive and specific enough to diagnose OC in the early stages. A lack of early symptoms and an effective asymptomatic population screening strategy leads to a poor prognosis in OC. New diagnostic and screening methods are urgently needed for early OC diagnosis. Liquid biopsies have been considered as a new noninvasive and promising method, using plasma/serum, uterine lavage, and urine samples for early cancer detection. We analyzed recent studies on molecular biomarkers with specific emphasis on liquid biopsy methods and diagnostic efficacy for OC through the detection of circulating tumor cells, circulating cell-free DNA, small noncoding RNAs, and tumor-educated platelets.
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Ramirez-Garzon O, Soares Magalhaes R, Satake N, Hill J, Jimenez C, Holland MK, McGowan M. Effect of Endometrial Sampling Procedures on Subsequent Pregnancy Rate of Cattle. Animals (Basel) 2021; 11:1683. [PMID: 34198740 DOI: 10.3390/ani11061683] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2021] [Revised: 05/31/2021] [Accepted: 06/02/2021] [Indexed: 12/27/2022] Open
Abstract
Simple Summary An important concern about conducting endometrial sampling procedures prior to breeding is the potential adverse effect on subsequent fertility of sampled cattle. Traumatic injury to the cervix and uterus and risk of introduction of infection caused by these sampling procedures may adversely affect the fertility of cattle sampled prior to breeding. To investigate this, a systematic review of publications assessing the impact of endometrial sampling on subsequent pregnancy rates was conducted. Analysis within the studies selected demonstrated that pregnancy rates were similar between sampled and non-sampled animals when procedures were performed before or around the time of breeding. Unfortunately, it was not possible to compare each sampling procedure between studies due to variation in sampling conditions (i.e., type of breed, age, reproductive status, and the sampling to breeding interval). We concluded that conducting these endometrial sampling procedures does not adversely affect subsequent fertility; therefore they could be used to more accurately identify cattle with a normal endometrium prior to conducting procedures such as embryo transfer. However, further studies with a much larger number of cattle are needed to verify the effects of endometrial sampling on pregnancy rates. Abstract Endometrial infections are a common cause of reproductive loss in cattle. Accurate diagnosis is important to reduce the economic losses caused by endometritis. A range of sampling procedures have been developed which enable collection of endometrial tissue or luminal cells or uterine fluid. However, as these are all invasive procedures, there is a risk that sampling around the time of breeding may adversely affect subsequent pregnancy rate. This systematic review compared the pregnancy rates (PR) of cattle which underwent uterine lavage (UL), cotton swab (CS), cytobrush (CB), cytotape (CT), or endometrial biopsy (EB) sampling procedures with those that were not sampled. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) protocol, relevant databases, including Pubmed, Web of Science, CAB Abstracts, VetMed Resource–Ruminants, and Scopus, were searched. The outcome measured was the pregnancy rate after the collection of endometrial sample(s). Seven studies, involving a total of 3693 cows, fulfilled the inclusion criteria for the systematic review and allowed the comparison of PR between sampled (n = 1254) and non-sampled cows (n = 2409). The results of the systematic review showed that endometrial sampling procedures can be performed before breeding or shortly after insemination without adversely affecting pregnancy rates in cattle. However, further studies are needed to validate this information.
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Munné S, Nakajima ST, Najmabadi S, Sauer MV, Angle MJ, Rivas JL, Mendieta LV, Macaso TM, Sawarkar S, Nadal A, Choudhary K, Nezhat C, Carson SA, Buster JE. First PGT-A using human in vivo blastocysts recovered by uterine lavage: comparison with matched IVF embryo controls†. Hum Reprod 2021; 35:70-80. [PMID: 31886877 PMCID: PMC6993848 DOI: 10.1093/humrep/dez242] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Revised: 09/07/2019] [Indexed: 01/10/2023] Open
Abstract
STUDY QUESTION After controlled ovarian stimulation (COS) and IUI, is it clinically feasible to recover in vivo conceived and matured human blastocysts by uterine lavage from fertile women for preimplantation genetic testing for aneuploidy (PGT-A) and compare their PGT-A and Gardner scale morphology scores with paired blastocysts from IVF control cycles? SUMMARY ANSWER In a consecutive series of 134 COS cycles using gonadotrophin stimulation followed by IUI, uterine lavage recovered 136 embryos in 42% (56/134) of study cycles, with comparable in vivo and in vitro euploidy rates but better morphology in in vivo embryos. WHAT IS KNOWN ALREADY In vivo developed embryos studied in animal models possess different characteristics compared to in vitro developed embryos of similar species. Such comparative studies between in vivo and in vitro human embryos have not been reported owing to lack of a reliable method to recover human embryos. STUDY DESIGN, SIZE, DURATION We performed a single-site, prospective controlled trial in women (n = 81) to evaluate the safety, efficacy and feasibility of a novel uterine lavage catheter and fluid recovery device. All lavages were performed in a private facility with a specialized fertility unit, from August 2017 to June 2018. Subjects were followed for 30 days post-lavage to monitor for clinical outcomes and delayed complications. In 20 lavage subjects, a single IVF cycle (control group) with the same ovarian stimulation protocol was performed for a comparison of in vivo to in vitro blastocysts. PARTICIPANTS/MATERIALS, SETTINGS, METHODS Women were stimulated with gonadotrophins for COS. The ovulation trigger was given when there were at least two dominant follicles ≥18 mm, followed by IUI of sperm. Uterine lavage occurred 4–6 days after the IUI. A subset of 20 women had a lavage cycle procedure followed by an IVF cycle (control IVF group). Recovered embryos were characterized morphologically, underwent trophectoderm (TE) biopsy, vitrified and stored in liquid nitrogen. Biopsies were analyzed using the next-generation sequencing technique. After lavage, GnRH antagonist injections were administered to induce menstruation. MAIN RESULTS AND THE ROLE OF CHANCE A total of 134 lavage cycles were performed in 81 women. Uterine lavage recovered 136 embryos in 56 (42%) cycles. At the time of cryopreservation, there were 40 (30%) multi-cell embryos and 96 (70%) blastocysts. Blastocysts were of good quality, with 74% (70/95) being Gardener grade 3BB or higher grade. Lavage blastocysts had significantly higher morphology scores than the control IVF embryos as determined by chi-square analysis (P < 0.05). This is the first study to recover in vivo derived human blastocysts following ovarian stimulation for embryo genetic characterization. Recovered blastocysts showed rates of chromosome euploidy similar to the rates found in the control IVF embryos. In 11 cycles (8.2%), detectable levels of hCG were present 13 days after IUI, which regressed spontaneously in two cases and declined after an endometrial curettage in two cases. Persistent hCG levels were resolved after methotrexate in three cases and four cases received both curettage and methotrexate. LIMITATIONS, REASON FOR CAUTION The first objective was to evaluate the feasibility of uterine lavage following ovarian stimulation to recover blastocysts for analysis, and that goal was achieved. However, the uterine lavage system was not completely optimized in our earlier experience to levels that were achieved late in the clinical study and will be expected in clinical service. The frequency of chromosome abnormalities of in vivo and IVF control embryos was similar, but this was a small-size study. However, compared to larger historical datasets of in vitro embryos, the in vivo genetic results are within the range of high-quality in vitro embryos. WIDER IMPLICATIONS OF THE FINDINGS Uterine lavage offers a nonsurgical, minimally invasive strategy for recovery of embryos from fertile women who do not want or need IVF and who desire PGT, fertility preservation of embryos or reciprocal IVF for lesbian couples. From a research and potential clinical perspective, this technique provides a novel platform for the use of in vivo conceived human embryos as the ultimate benchmark standard for future and current ART methods. STUDY FUNDING/COMPETING INTEREST(S) Previvo Genetics, Inc., is the sole sponsor for the Punta Mita, Mexico, clinical study. S.M. performs consulting for CooperGenomics. J.E.B. and S.A.C. are co-inventors on issued patents and patents owned by Previvo and ownshares of Previvo. S.N. is a co-author on a non-provisional patent application owned by Previvo and holds stock options in Previvo. S.T.N. and M.J.A. report consulting fees from Previvo. S.T.N., S.M., M.V.S., M.J.A., C.N. and J.E.B. are members of the Previvo Scientific Advisory Board (SAB) and hold stock options in Previvo. J.E.B and S. M are members of the Previvo Board of Directors. A.N. and K.C. are employees of Previvo Genetics. L.V.M, T.M.M, J.L.R and S. S have no conflicts to disclose. TRIAL REGISTRATION NUMBER Protocol Registration and Results System (PRS) Trial Registration Number and Name: Punta Mita Study TD-2104: Clinical Trials NCT03426007.
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Affiliation(s)
- Santiago Munné
- CooperGenomics, 3 Regent St., Suite 301, Livingston, NJ 07039, USA.,Overture Life, Avenida de Europa 4, Alcobendas, Madrid 28108, Spain.,Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, 310 Cedars Street, RM 337, New Haven, CT 06510, USA
| | - Steven T Nakajima
- Department of Obstetrics and Gynecology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Sam Najmabadi
- Center for Reproductive Health and Gynecology, 99 N. La Cienega Blvd., Suite 109, Beverly Hills, CA 90211, USA.,Punta Mita Fertility Center/Center for Reproductive Health and Gynecology, Punta Mita Hospital, Ramal Carretera Federal 200 KM 19 No. 1, Punta Mita, Nayarit C.P. 63734, Mexico
| | - Mark V Sauer
- Department of Obstetrics, Gynecology and Reproductive Sciences, Rutgers Robert Wood Johnson Medical School, Clinical Academic Building, 125 Paterson St., Room 2150, New Brunswick, NJ 08901, USA
| | - Marlane J Angle
- Laurel Fertility Care, 1700 California St., San Francisco, CA 94109, USA
| | - José L Rivas
- Punta Mita Fertility Center/Center for Reproductive Health and Gynecology, Punta Mita Hospital, Ramal Carretera Federal 200 KM 19 No. 1, Punta Mita, Nayarit C.P. 63734, Mexico
| | - Laura V Mendieta
- Punta Mita Fertility Center/Center for Reproductive Health and Gynecology, Punta Mita Hospital, Ramal Carretera Federal 200 KM 19 No. 1, Punta Mita, Nayarit C.P. 63734, Mexico
| | - Thelma M Macaso
- Center for Reproductive Health and Gynecology, 99 N. La Cienega Blvd., Suite 109, Beverly Hills, CA 90211, USA
| | - Sarthak Sawarkar
- CooperGenomics, 3 Regent St., Suite 301, Livingston, NJ 07039, USA
| | - Alexander Nadal
- Previvo Genetics, Inc., 1599 Industrial Road, San Carlos, CA 94070, USA
| | - Kajal Choudhary
- Previvo Genetics, Inc., 1599 Industrial Road, San Carlos, CA 94070, USA
| | - Camran Nezhat
- Center for Special Minimally Invasive and Robotic Surgery, 900 Welch Road, #403, Palo Alto, CA 94304, USA
| | - Sandra A Carson
- Department of Obstetrics, Gynecology and Reproductive Sciences, Yale University, 310 Cedars Street, RM 337, New Haven, CT 06510, USA
| | - John E Buster
- Previvo Genetics, Inc., 1599 Industrial Road, San Carlos, CA 94070, USA.,Department of Obstetrics and Gynecology, Warren Alpert Medical School of Brown University, 101 Dudley St., Providence, RI 02905, USA
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Abstract
Uterine lavage is presented as a way to perform aneuploidy screening without IVF. The feasibility of this method was tested in a research study. This study combined a number of highly contentious ethical issues: the creation of embryos for research (very early), abortion and (moderate) payments to research participants. It is concluded that the study largely fulfils the criteria of ethical research but that the researchers should have avoided a number of steps. These steps were the inclusion of infertility patients, the performance of the research in a middle-income country and the double destination of the embryos. The next question then becomes whether it would be acceptable to apply the method in a clinical setting. Two elements complicate the introduction in the clinic: low success rate of embryo collection and risk of unintended pregnancy. The application of the method in the clinic may lead to very complicated ethical and legal situations for which both patients and doctors should be prepared.
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Affiliation(s)
- Guido Pennings
- Department of Philosophy and Moral Science, Ghent University, Gent 9000, Belgium
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Almiñana C, Rudolf Vegas A, Tekin M, Hassan M, Uzbekov R, Fröhlich T, Bollwein H, Bauersachs S. Isolation and Characterization of Equine Uterine Extracellular Vesicles: A Comparative Methodological Study. Int J Mol Sci 2021; 22:ijms22020979. [PMID: 33478136 PMCID: PMC7835857 DOI: 10.3390/ijms22020979] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2021] [Revised: 01/15/2021] [Accepted: 01/16/2021] [Indexed: 12/14/2022] Open
Abstract
Extracellular vesicles (EVs) have been identified in the uterine fluid in different species and have been pointed as key players in the embryo-maternal dialogue, maternal recognition of pregnancy and establishment of pregnancy. However, little is known about the uterine EVs in the mare. Therefore, the present study aimed at characterizing EVs from uterine lavage of cyclic mares by comparing five EVs isolation methods and the combination of them: (1) ultracentrifugation (UC); (2) concentration of lavage volume by Centricon ultrafiltration (CE); (3) the use of CE with different washing steps (phosphate-buffered saline with or without trehalose); (4) size-exclusion chromatography with iZON-qEV columns, and (5) a combination of the methods with best results based on EVs yield, purity, and protein cargo profiles. Transmission electron microscopy and Western blotting confirmed the isolation of EVs by all methods but with quantitative and qualitative differences. Mass spectrometry provided differences in protein profiles between methods, number of identified proteins, and protein classes. Our results indicate that the combination of CE/trehalose/iZON/UC is an optimal method to isolate equine uterine EVs with good yield and purity that can be applied in future studies to determine the role of equine uterine EVs in embryo-maternal interactions.
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Affiliation(s)
- Carmen Almiñana
- Functional Genomics Group, Institute of Veterinary Anatomy, Vetsuisse Faculty Zurich, University of Zurich, 8315 Lindau, Switzerland; (A.R.V.); (S.B.)
- UMR85 PRC, INRAE, CNRS 7247, Université de Tours, IFCE, 37380 Nouzilly, France
- Correspondence:
| | - Alba Rudolf Vegas
- Functional Genomics Group, Institute of Veterinary Anatomy, Vetsuisse Faculty Zurich, University of Zurich, 8315 Lindau, Switzerland; (A.R.V.); (S.B.)
- Clinic of Reproductive Medicine, Department for Farm Animals, Vetsuisse-Faculty, University of Zurich, 8057 Zurich, Switzerland; (M.T.); (M.H.); (H.B.)
| | - Muhittin Tekin
- Clinic of Reproductive Medicine, Department for Farm Animals, Vetsuisse-Faculty, University of Zurich, 8057 Zurich, Switzerland; (M.T.); (M.H.); (H.B.)
| | - Mubbashar Hassan
- Clinic of Reproductive Medicine, Department for Farm Animals, Vetsuisse-Faculty, University of Zurich, 8057 Zurich, Switzerland; (M.T.); (M.H.); (H.B.)
| | - Rustem Uzbekov
- Laboratoire Biologie Cellulaire et Microscopie Electronique, Faculté de Médecine, Université de Tours, 37032 Tours, France;
- Faculty of Bioengineering and Bioinformatics, Moscow State University, 119992 Moscow, Russia
| | - Thomas Fröhlich
- Gene Center, Laboratory for Functional Genome Analysis, LMU Munich, 81377 Munich, Germany;
| | - Heinrich Bollwein
- Clinic of Reproductive Medicine, Department for Farm Animals, Vetsuisse-Faculty, University of Zurich, 8057 Zurich, Switzerland; (M.T.); (M.H.); (H.B.)
| | - Stefan Bauersachs
- Functional Genomics Group, Institute of Veterinary Anatomy, Vetsuisse Faculty Zurich, University of Zurich, 8315 Lindau, Switzerland; (A.R.V.); (S.B.)
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Köhne M, Kuhlmann M, Tönißen A, Martinsson G, Sieme H. Diagnostic and Treatment Practices of Equine Endometritis-A Questionnaire. Front Vet Sci 2020; 7:547. [PMID: 32984410 PMCID: PMC7492380 DOI: 10.3389/fvets.2020.00547] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Accepted: 07/13/2020] [Indexed: 11/13/2022] Open
Abstract
Endometritis is a major cause for impaired fertility in mares. The objectives of this study were to collect information on diagnostic and treatment practices performed by veterinarians and to investigate possible effects of professional experience, caseload, and geographical location on the practitioners' management of endometritis cases. For this purpose, equine practitioners (n = 680) were asked to fill out an online survey (34 questions). The online survey yielded 117 responses by veterinarians practicing in all parts of Germany. Most respondents came from Lower Saxony and managed <20 mares per year. For the diagnosis of chronic infectious endometritis, uterine sampling for microbiological examination was performed manually with a swab by the majority of practitioners whereas only few used the speculum technique. The incidence of antibiotic resistant pathogens was reported to be <5% by almost all respondents. Most practitioners relied on systemic antibiotic treatment with trimethoprim-sulfadiazine. Only occasionally veterinarians used intrauterine antibiotic therapy. Uterine lavages were performed routinely by almost half of the respondents in case of positive uterine cultures, mostly with 0.9% saline solution. Irritant solutions (e.g., iodine, chlorhexidine, kerosene) were used less often. Collection of an endometrial culture after completion of the treatment was common practice. While only a very limited association of the geographical location of practitioner (e.g., on selection of mares for endometrial culture, p < 0.05) was observed, the number of managed mares affected the answers notably (e.g., for use of irritating intrauterine treatment, p < 0.05). The management of persistent breeding induced endometritis (PBIE) was influenced by the number of managed mares (e.g., for use of oxytocin, p < 0.05) and 29.6% of respondents administered antibiotics as part of their PBIE management. In summary, treatment strategies in the field vary considerably and include also non-evidence-based methods, but most German practitioners apply the recommended suitable treatments. Following the guidelines for antibiotic usage, most veterinarians administer antibiotics dependent on endometrial culture results but do not use cytology, low-volume lavage, or biopsy routinely. Antibiotic resistant uterine pathogens are reported to be isolated infrequently and equine practitioners prefer systemic to local antibiotic treatment of endometritis.
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Affiliation(s)
- Martin Köhne
- Clinic for Horses – Unit for Reproductive Medicine, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | | | - Anna Tönißen
- Clinic for Horses – Unit for Reproductive Medicine, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
| | | | - Harald Sieme
- Clinic for Horses – Unit for Reproductive Medicine, University of Veterinary Medicine Hannover, Foundation, Hanover, Germany
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Tohma YA, Musabak U, Gunakan E, Akilli H, Onalan G, Zeyneloglu HB. The Role of Analysis of NK Cell Subsets in Peripheral Blood and Uterine Lavage Samples in Evaluation of Patients with Recurrent Implantation Failure. J Gynecol Obstet Hum Reprod 2020; 49:101793. [PMID: 32413518 DOI: 10.1016/j.jogoh.2020.101793] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2020] [Revised: 04/25/2020] [Accepted: 04/27/2020] [Indexed: 10/24/2022]
Abstract
OBJECTIVE In this study, we aimed to determine the role of analyses of NK cell subsets in peripheral blood and uterine lavage samples in evaluation of patients with unexplained RIF. METHODS This retrospective single-institution case-control study included two different cohorts between 2017-2019. First cohort included patients examined with peripheral blood samples for evaluation of possible immunologic problems in patients with unexplained recurrent implantation failure; in the study period, a total of 75 consecutive patients with RIF (study group; n: 42) or infertile patients without RIF (control group; n: 33) were included. Second cohort included those patients whose uterine samples were assessed for immunologic problems; RIF (study group ; n: 16) or infertile patients without RIF (control group; n: 25). RESULTS In the first cohort, the percentage of NK cells (CD3-CD16+56+) is statistically significantly lower (9.8 vs. 12.6, respectively, p: 0.038) in the study group than those of the controls whereas there was no statistical significance in the absolute number of NK cells (CD3-CD16+56+). In the second cohort, the only remarkable finding in uterine lavage samples was significantly increased uNKs cells (CD3-CD16dim56bright) percentages in controls (9.95 vs 12.7, respectively, p: 0.026) compared to those of study group. CONCLUSION Our data shows that the analysis of NK cell subtypes in peripheral blood does not seem appropriate to investigate the patients with RIF and we suggest that uterine lavage samples instead of peripheral blood samples be implemented and evaluated.
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Affiliation(s)
- Yusuf Aytac Tohma
- Baskent University School of Medicine, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Ugur Musabak
- Baskent University School of Medicine, Department of Immunology, Ankara, Turkey
| | - Emre Gunakan
- Baskent University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Huseyin Akilli
- Baskent University School of Medicine, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Gogsen Onalan
- Baskent University School of Medicine, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Ankara, Turkey
| | - Hulusi Bulent Zeyneloglu
- Baskent University School of Medicine, Division of Reproductive Endocrinology and Infertility, Department of Obstetrics and Gynecology, Ankara, Turkey.
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Salk JJ, Loubet-Senear K, Maritschnegg E, Valentine CC, Williams LN, Higgins JE, Horvat R, Vanderstichele A, Nachmanson D, Baker KT, Emond MJ, Loter E, Tretiakova M, Soussi T, Loeb LA, Zeillinger R, Speiser P, Risques RA. Ultra-Sensitive TP53 Sequencing for Cancer Detection Reveals Progressive Clonal Selection in Normal Tissue over a Century of Human Lifespan. Cell Rep 2019; 28:132-144.e3. [PMID: 31269435 PMCID: PMC6639023 DOI: 10.1016/j.celrep.2019.05.109] [Citation(s) in RCA: 56] [Impact Index Per Article: 11.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2018] [Revised: 04/06/2019] [Accepted: 05/29/2019] [Indexed: 01/08/2023] Open
Abstract
High-accuracy next-generation DNA sequencing promises a paradigm shift in early cancer detection by enabling the identification of mutant cancer molecules in minimally invasive body fluid samples. We demonstrate 80% sensitivity for ovarian cancer detection using ultra-accurate Duplex Sequencing to identify TP53 mutations in uterine lavage. However, in addition to tumor DNA, we also detect low-frequency TP53 mutations in nearly all lavages from women with and without cancer. These mutations increase with age and share the selection traits of clonal TP53 mutations commonly found in human tumors. We show that low-frequency TP53 mutations exist in multiple healthy tissues, from newborn to centenarian, and progressively increase in abundance and pathogenicity with older age across tissue types. Our results illustrate that subclonal cancer evolutionary processes are a ubiquitous part of normal human aging, and great care must be taken to distinguish tumor-derived from age-associated mutations in high-sensitivity clinical cancer diagnostics.
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Affiliation(s)
- Jesse J Salk
- Department of Medicine, Division of Medical Oncology, University of Washington, Seattle, WA 98195, USA; TwinStrand Biosciences, Seattle, WA 98121, USA
| | | | - Elisabeth Maritschnegg
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | | | | | | | - Reinhard Horvat
- Department of Pathology, Medical University of Vienna, Vienna, Austria
| | - Adriaan Vanderstichele
- Department of Gynecologic Oncology, Leuven Cancer Institute, University Hospitals Leuven, Katholieke Universiteit, Leuven, Belgium
| | - Daniela Nachmanson
- Department of Pathology, University of Washington, Seattle, WA 98195, USA
| | - Kathryn T Baker
- Department of Pathology, University of Washington, Seattle, WA 98195, USA
| | - Mary J Emond
- Department of Statistics, University of Washington, Seattle, WA 98195, USA
| | - Emily Loter
- Department of Pathology, Seattle Children's Hospital, Seattle, WA 98105, USA
| | - Maria Tretiakova
- Department of Pathology, University of Washington, Seattle, WA 98195, USA
| | - Thierry Soussi
- Sorbonne Université, UPMC Université Paris 06, 75005 Paris, France; Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden; INSERM, U1138, Centre de Recherche des Cordeliers, Paris, France
| | - Lawrence A Loeb
- Department of Pathology, University of Washington, Seattle, WA 98195, USA
| | - Robert Zeillinger
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Paul Speiser
- Molecular Oncology Group, Department of Obstetrics and Gynecology, Comprehensive Cancer Center-Gynecologic Cancer Unit, Medical University of Vienna, Vienna, Austria
| | - Rosa Ana Risques
- Department of Pathology, University of Washington, Seattle, WA 98195, USA.
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11
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Nadal A, Najmabadi S, Addis B, Buster JE. Novel uterine lavage system for recovery of human embryos fertilized and matured in vivo. Med Devices (Auckl) 2019; 12:133-141. [PMID: 31118836 PMCID: PMC6503331 DOI: 10.2147/mder.s193067] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 02/26/2019] [Indexed: 11/23/2022] Open
Abstract
Purpose: In this paper we describe a novel uterine lavage system for the recovery of in vivo preimplantation embryos. Currently, no other method exists to retrieve preimplantation embryos except for in vitro fertilization (IVF). Methods: A single center, prospective feasibility study was conducted to test a novel uterine lavage system for the recovery of in vivo preimplantation embryos in egg donors and patients seeking pregnancy. Subjects were placed on controlled ovarian hyperstimulation followed by intrauterine insemination (IUI) and uterine lavage performed approximately 4–6 days after IUI. Subjects were followed up for 30 days after the procedure to monitor for safety events. Results: A total of 134 uterine lavage cycles were performed on 81 subjects (average: 1.7 cycles/subject). Ova (oocytes or embryos) were collected in 53% (71/134) of the cycles with steady improvement of recovery efficiency over the course of the study, and embryos collected in 42% (56/134) of cycles. Embryos of many stages were collected, but 71% (96/136) of embryos collected were blastocyst stage embryos which are at the most advanced stage of embryogenesis. Embryos recovered were of good quality based on blastocyst gradings in which 74% (70/95, 1 blastocyst not graded) of the blastocysts were good quality as determined by the Gardner Scale of Morphology. The procedure was well tolerated with minor side effects. In 8% of cycles a positive hCG was observed after the lavage indicating some embryos were not recovered by the lavage system. Conclusion: Through this work the system has been shown to recover embryos from the uterus in a safe and effective manner, thus opening the possibility that uterine lavage may serve as an alternative to IVF where patient indications allow.
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Affiliation(s)
- Alexander Nadal
- Department of Research and Development, Previvo Genetics, San Carlos, CA 94070, USA
| | - Sam Najmabadi
- Division of Reproductive Endocrinology and Infertility, Punta Mita Hospital, Punta Mita, Nayarit 63734, Mexico.,Division of Reproductive Endocrinology and Infertility, Center for Reproductive Health and Infertility, Beverly Hills, CA 90211, USA
| | - Bruce Addis
- Department of Research and Development, Previvo Genetics, San Carlos, CA 94070, USA
| | - John E Buster
- Department of Research and Development, Previvo Genetics, San Carlos, CA 94070, USA.,Division of Reproductive Endocrinology and Infertility, Warren Alpert Medical School of Brown University, Providence, RI 02903, USA
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12
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Heng S, Stephens AN, Jobling TW, Nie G. Measuring PC activity in endocervical swab may provide a simple and non-invasive method to detect endometrial cancer in post-menopausal women. Oncotarget 2018; 7:46573-46578. [PMID: 27374098 PMCID: PMC5216818 DOI: 10.18632/oncotarget.10287] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2016] [Accepted: 05/20/2016] [Indexed: 11/25/2022] Open
Abstract
Endometrial cancer is one of the most common gynecological malignancies in post-menopausal women. If detected at early stages, endometrial cancer can be effectively treated by abdominal hysterectomy. However, to date, there is no biochemical test available for early and easy detection of endometrial cancer. Our previous study has established that the total proprotein convertase (PC) activity is significantly increased in the uterine lavage of post-menopausal women with endometrial cancer. Uterine lavage can be obtained relatively non-invasively compared to uterine tissues, however, blood contamination and other factors limit the wide clinical use of uterine lavage. The aim of this study was to determine whether endocervical swab is a viable alternative to uterine lavage for the detection of endometrial cancer. We determined the correlation in PC activity between paired endocervical swabs and uterine lavages from individual post-menopausal women (control as well as endometrial cancer patients), and also compared the total PC activity in endocervical swabs between control and endometrial cancer patients. Our data demonstrated that the total PC activity in swab and lavage was highly correlative in post-menopausal women, and that the PC activity in endocervical swab was significantly increased in endometrial cancer patients compared to controls. These results strongly suggest that determining PC activity in endocervical swabs may provide a simple, non-invasive and novel method to detect endometrial cancer in post-menopausal women.
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Affiliation(s)
- Sophea Heng
- Implantation and Placental Development Laboratory, Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Victoria, Australia.,Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia.,Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia
| | - Andrew N Stephens
- Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia.,Centre for Cancer Research, Hudson Institute of Medical Research, Clayton, Victoria, Australia.,Epworth Research Institute, Epworth HealthCare, Richmond, Victoria, Australia
| | - Tom W Jobling
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia.,Epworth Research Institute, Epworth HealthCare, Richmond, Victoria, Australia
| | - Guiying Nie
- Implantation and Placental Development Laboratory, Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Victoria, Australia.,Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia.,Department of Biochemistry and Molecular Biology, Monash University, Clayton, Victoria, Australia
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13
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Heng S, Vollenhoven B, Rombauts LJ, Nie G. A High-Throughput Assay for the Detection of α-Dystroglycan N-Terminus in Human Uterine Fluid to Determine Uterine Receptivity. ACTA ACUST UNITED AC 2015; 21:408-13. [PMID: 26637554 DOI: 10.1177/1087057115619127] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2015] [Accepted: 11/02/2015] [Indexed: 11/15/2022]
Abstract
Embryo implantation requires a healthy embryo and a receptive uterus. In women, the uterus remains a hostile environment and must undergo functional changes to convert to a receptive state for embryo implantation. Determining uterine receptivity is vital in IVF treatment, as the timing of embryo transfer needs to be synchronized with uterine receptivity. However, to date, no reliable biochemical tests are available to determine uterine receptivity. We recently established that removal of α-dystroglycan N-terminus (α-DG-N) from the uterine surface plays an important role in the establishment of uterine receptivity. Importantly, the α-DG-N removed from the uterine tissue enters into the uterine fluid, and the levels correlate with the tissue status of receptivity. Detection of α-DG-N in uterine fluid may therefore provide a nonsurgical approach to assess uterine receptivity. In this study, we first validated three monoclonal antibodies raised against α-DG-N in our system, and then established a sandwich ELISA suitable for the detection of α-DG-N in human uterine fluid. This ELISA detected significantly higher concentrations of α-DG-N in uterine fluid of women in the receptive phase. We believe this newly established α-DG-N ELISA may provide an important tool in the development of noninvasive strategies to detect uterine receptivity in women.
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Affiliation(s)
- Sophea Heng
- Implantation and Placental Development Laboratory, Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Victoria, Australia Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia
| | - Beverley Vollenhoven
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia Monash IVF, Clayton, Victoria, Australia
| | - Luk J Rombauts
- Department of Obstetrics and Gynaecology, Monash University, Clayton, Victoria, Australia Monash IVF, Clayton, Victoria, Australia
| | - Guiying Nie
- Implantation and Placental Development Laboratory, Centre for Reproductive Health, Hudson Institute of Medical Research, Clayton, Victoria, Australia Department of Molecular and Translational Sciences, Monash University, Clayton, Victoria, Australia
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