Banca de DEFESA: DÉLIS DE OLIVEIRA FERREIRA

Uma banca de DEFESA de DOUTORADO foi cadastrada pelo programa.
STUDENT : DÉLIS DE OLIVEIRA FERREIRA
DATE: 22/04/2025
TIME: 08:30
LOCAL: Centro de Biociências - UFRN
TITLE:

Desenvolvimento de um protocolo de baixo custo para o rastreio da endometrite crônica

KEY WORDS:

Endometrium; Plasma cell; CD138; Microbiota; Supracytoplasmic bacilli;

PAGES: 126
BIG AREA: Ciências da Saúde
AREA: Farmácia
SUMMARY:

Chronic endometritis (CE) is characterized by the inflammation of the endometrium, the
tissue that lines the uterine cavity, and is associated with clinical manifestations that
include menstrual irregularities, pelvic pain, obstetric complications, and infertility.
However, the absence of specific symptoms can complicate the early and accurate
identification of the disease. This diagnostic difficulty also lies in the fact that available
methods have limitations in sensitivity and specificity, highlighting the need for the
development of an efficient and cost-effective diagnostic protocol for the disease. In this
context, this research proposed innovative approaches for the early identification of the
disease and the development of an accessible, precise, and clinically relevant protocol. To
this end, a literature review was conducted with the aim of presenting a panel that includes
the main bacterial genera associated with endometritis. The most frequently cited genera
were Chlamydia spp., Ureaplasma spp., Streptococcus spp., Mycoplasma spp., and
Enterococcus spp., all of which are related to significant endometrial inflammatory
changes. To compare different methods for performing endometrial biopsy regarding
their viability in diagnosing endometritis through histopathological and
immunohistochemical analyses for CD138, CD56, and PGP 9.5, endometrial tissue
samples were collected from patients treated in the surgical hysteroscopy department at
the Maternidade Escola Januário Cicco (MEJC), Natal-RN. The endometrial tissue was
obtained through hysteroscopy, Cornier pipelle, and a urethral catheter (Nelaton®)
attached to a syringe. No significant differences were found between the histopathological
characterization and immunohistochemical staining when comparing the three collection
methods used. It is therefore suggested to use the urethral catheter attached to a syringe
as a new method for performing endometrial biopsy, as it is more financially accessible,
poses a lower risk of complications after the procedure, and is as efficient for obtaining
endometrial tissue as the other methods mentioned. Furthermore, to investigate the
relationship between the expression of CD138, clinical factors, and cervico-vaginal
cytological and microbiological characteristics, two methods of endometrial biopsy were
compared: hysteroscopy and endometrial catheter. Samples from women in their
reproductive years, without a history of chronic disease, were analyzed. The samples
underwent immunohistochemical analyses, cervico-vaginal cytology, Nugent Score, and
molecular pathogen detection by qPCR. Clinical factors such as age, reproductive history,
and uterine pathologies were not associated with the presence of plasma cells in the
endometrium. The significant association of hormone use, flora deviation with
supracytoplasmic bacilli, and the detection of intact and degenerated red blood cells in
the cervico-vaginal region, with the increase of plasma cells marked with the CD138
antibody, suggest a relevant role in the pathophysiology of CE, possibly contributing to a
persistent inflammatory environment. Furthermore, these data reinforce the importance
of cytological analysis as a complementary test in identifying patients with the disease.
Together, these data show that the presence of the mentioned microorganisms in the
endometrium may compromise female reproductive health, and that the use of a Nelaton®
urethral catheter adapted for biopsy purposes could emerge as a promising way to obtain
endometrial tissue samples, whether for microscopic tissue analysis or for identifying
microorganisms related to CE, as well as identifying other uterine pathologies.

 

COMMITTEE MEMBERS:
Externa ao Programa - 1199080 - ANA KATHERINE DA SILVEIRA GONCALVES DE OLIVEIRA - UFRNExterna à Instituição - AYANE CRISTINE ALVES SARMENTO - UFRN
Externa à Instituição - JANAINA FERREIRA ADERALDO - UFRN
Presidente - 1714294 - MARCIO FERRARI
Externo à Instituição - RICARDO NEY OLIVEIRA COBUCCI - EBSERH