Immune responses during the peripartum period in dairy cows with postpartum endometritis

Reproductive tract defense and disease in postpartum dairy cows

This paper briefly reviews recent data and concepts on the development and mitigation of infection and inflammation in the reproductive tract of dairy cows during the first 2 mo after calving. The incidence of metritis is typically between 10 and 20%, of clinical endometritis or purulent vaginal discharge (PVD) approximately 15%, and of subclinical or cytological endometritis a further 15%. Worse postpartum negative energy balance is associated with more severe or prolonged uterine inflammation. Changes in feed intake, expression of genes for pro-inflammatory cytokines, notably interleukin (IL) 1, IL6 and IL8, circulating concentrations of beta-hydroxybutyrate (BHBA) or nonesterified fatty acids (NEFA), and innate immune function precede both metritis and endometritis by several weeks. Infections with Escherichia coli and Arcanobacterium pyogenes are associated with both metritis and PVD. There are new data to suggest that specific virulence factors in E. coli associated with adherence may be important in metritis and PVD. Cytological endometritis and PVD are overlapping but largely distinct conditions, and there are emerging data that cervicitis exists both concurrent with and separate from endometritis. Much remains to be learned about what initiates and sustains harmful inflammation of the reproductive tract. Such information is necessary to develop effective treatments for the various forms of disease and, more importantly, to develop means to prevent endometritis and cervicitis. In particular, vaccination against specific uterine pathogens and interventions to modulate innate immune response appear to be important avenues for investigation. Presently, commonly recommended best management practices for cows in the transition period are likely to be helpful to mitigate the risk of reproductive disease.

Association between interleukin-8 receptor-α (CXCR1) polymorphism and disease incidence, production, reproduction, and survival in Holstein cows

The objective was to evaluate the association between the single nucleotide polymorphism at position +735 in the interleukin-8 receptor-α (CXCR1) gene (CXCR1c.735) and disease incidence, milk production, reproductive performance, and survival in Holstein cows. Three-hundred fifty Holstein cows were enrolled. No association was found between CXCR1c.735 genotype and retained fetal membranes, metritis, or endometritis. Incidence rate of clinical mastitis was associated with CXCR1c.735 genotype; cows with genotypes CC and GC had a decreased incidence rate of clinical mastitis compared with GG cows. Milk yield was associated with CXCR1c.735 genotype; cows with genotype GC had greater milk yield than GG cows. Hazard of pregnancy was not associated with CXCR1c.735 genotype. Cows that had clinical mastitis had decreased hazard of pregnancy, and cows that had endometritis tended to have a decreased hazard of pregnancy. Hazard of death or culling was not associated with CXCR1c.735 genotype. Multiparous cows and cows that had mastitis had increased hazard of death or culling. In contrast to what we expected, cows with the genotype GG had an increased incidence rate of clinical mastitis and decreased milk yield.

Association between endometritis and endometrial cytokine expression in postpartum Holstein cows

The endometrium regulates the inflammatory response after infection by production and release of cytokines and chemokines. The objective was to compare gene expression of important pro-inflammatory (TNFα, IL-1β, IL-6) and anti-inflammatory (IL-10) cytokines, and the main neutrophil chemokine (IL-8), from calving to Week 7 after calving, in cows that developed endometritis and healthy control cows. Uterine biopsies were obtained at calving and at Weeks 1, 3, 5 and 7. Endometritis was evaluated at Week 5 by uterine lavage and cytology; cows with ≥ 10% neutrophils were considered to have endometritis. Real-time RT-PCR threshold values (Ct) were used to calculate the fold difference in gene expression, using the 2(-ddCt) method, normalized to GAPDH and calibrated to the average dCt for all cows at calving. Serum IL-8 concentrations were measured with ELISA. The analysis included 28 cows (11 had endometritis) for the PCR data and 44 cows (20 had endometritis) for ELISA. Expression of the TNFα gene in uterine tissue was decreased in cows with endometritis compared to control cows at calving (P = 0.09) and at Week 1 (P = 0.05). Iterleukin-1β gene expression tended to be decreased (P = 0.08) in cows with endometritis compared to control cows at Week 1, but tended to be increased (P ≤ 0.10) at Weeks 5 and 7. Cows with endometritis had increased (P < 0.05) IL-6 gene expression at calving and at Week 7 compared to control cows. Interleukin-8 gene expression was increased (P = 0.03) in endometritic cows compared to control cows at Week 7. Uterine disease was not significantly associated with IL-10 gene expression. A lower local level of expression of pro-inflammatory cytokines in the endometrium soon after calving might impair activation of inflammation and clearance of bacteria, and lead to development of endometritis.

Monitoring metabolic health of dairy cattle in the transition period

This paper reviews the importance of energy metabolism in transition dairy cows, its associations with disease and reproduction, and strategies for monitoring cows under field conditions during this critical time. Essentially all dairy cattle experience a period of insulin resistance, reduced feed intake, negative energy balance, hypocalcemia, reduced immune function, and bacterial contamination of the uterus soon before, or in the weeks after calving. One-third of dairy cows may be affected by some form of metabolic or infectious disease in early lactation. Routine, proactive actions, observations, or analysis are intended to accurately and efficiently provide early detection of problems, to provide an opportunity for investigation and intervention in order to limit the consequences and costs of health problems and reduced animal performance or welfare. Methods of early detection include monitoring of disease and culling records, feed intake, milk production, body condition, and simple metabolic tests. Methods, strategies, and interpretation of measurement of peripartum concentrations of non-esterified fatty acids (NEFA) and beta-hydroxybutyrate (BHB) as indicators of aspects of energy status and disease risk are reviewed. High NEFA (> 0.4 mmol/l) in the last 7 to 10 days before expected calving is associated with increased risk of displaced abomasum (DA), retained placenta, culling before 60 days in milk, and less milk production in the first 4 months of lactation. Subclinical ketosis (serum BHB >1200 to 1400 micromol/l) in the first or second week after calving is associated with increased risk of DA, metritis, clinical ketosis, endometritis, prolonged postpartum anovulation, increased severity of mastitis, and lower milk production in early lactation. There are several validated and practical tools for cow-side measurement of ketosis.

Evaluation of the systemic acute phase response and endometrial gene expression of serum amyloid A and pro- and anti-inflammatory cytokines in mares with experimentally induced endometritis

Infectious infertility in the mare is clinically well described, little is however known about the systemic acute phase reaction (APR) and local immunological responses accompanying equine endometritis. The aim of this study was to monitor selected markers of the APR in the systemic circulation and to correlate them to the local innate immune response in the uterus during infectious endometritis. Six adult standard bred mares received an intrauterine infusion of 10(9)CFU Escherichia coli. Blood samples were obtained before (0 h) and 3, 6, 12, 24, 36, 48, 72, 96 and 120 h post inoculation (pi), and endometrial biopsies were sampled before, and 3, 12, 24, 48 and 72 h pi. The infectious endometritis elicited a systemic APR with significantly increased concentrations of the acute phase proteins (APPs) serum amyloid A (SAA) and fibrinogen. Relative gene expression analyses were performed on extracted RNA from endometrial biopsies using quantitative real-time PCR and specific primers for SAA and pro- and anti-inflammatory cytokines. Expression of SAA was significantly up-regulated at 3 and 12h pi, and a significant up-regulated expression of IL-1β, TNFα, IL-8 and IL-10 was observed at 3h pi. Plasma concentration of SAA was significantly correlated to endometrial SAA expression. The results of the present study demonstrate that endometritis gives rise to a systemic APR and an up-regulated endometrial gene expression of SAA and several pro-and anti-inflammatory cytokines. Understanding endometrial expression of acute phase proteins and selected cytokines contributing to uterine immunity in equine endometritis could improve understanding of events leading to infertility in the mare and help identify candidate genes of mediators/markers for diagnostic use.

Comparison of two methods of detecting purulent vaginal discharge in postpartum dairy cows and effect of intrauterine cephapirin on reproductive performance

OBJECTIVE

Part 1: compare the use of a Metricheck device (a stainless steel probe with a semi-spherical rubber cup attached at one end) to sample the contents of the anterior vagina with a vaginal speculum examination for the diagnosis of pus in the vagina of postpartum dairy cows and to investigate the association of that pus with reproductive performance. Part 2: assess the effect of a single intrauterine infusion of 500 mg cephapirin in cows diagnosed with vaginal purulent or mucopurulent discharge 7 to 28 days after calving on reproductive performance.

PROCEDURE

Six herds were visited fortnightly to examine cows that had calved between 7 and 28 days (n = 423) with both the Metricheck device and a vaginal speculum to score, by each method, the vaginal discharge from 0 (clear or absent) to 3 (purulent) for each animal included in the study. Half of the cows that had a positive discharge score (1 to 3 by either examination method) were then treated with an intrauterine infusion of 500 mg of cephapirin. The relationship between Metricheck score, vaginoscopy score, treatment and reproductive performance was assessed.

RESULTS

There was a substantial measure of agreement between each method when scores were analysed by status. Cows that were positive with either method had inferior reproductive performance compared with cows with a score of zero. Treatment of cows diagnosed with a purulent or mucopurulent discharge with intrauterine cephapirin improved reproductive performance in both the vaginoscopy and Metricheck groups.

Defining postpartum uterine disease and the mechanisms of infection and immunity in the female reproductive tract in cattle

Uterine microbial disease affects half of all dairy cattle after parturition, causing infertility by disrupting uterine and ovarian function. Infection with Escherichia coli, Arcanobacterium pyogenes, and bovine herpesvirus 4 causes endometrial tissue damage. Toll-like receptors on endometrial cells detect pathogen-associated molecules such as bacterial DNA, lipids, and lipopolysaccharide (LPS), leading to secretion of cytokines, chemokines, and antimicrobial peptides. Chemokines attract neutrophils and macrophages to eliminate the bacteria, although persistence of neutrophils is associated with subclinical endometritis and infertility. Cows with uterine infections are less likely to ovulate because they have slower growth of the postpartum dominant follicle in the ovary, lower peripheral plasma estradiol concentrations, and perturbation of hypothalamic and pituitary function. The follicular fluid of animals with endometritis contains LPS, which is detected by the TLR4/CD14/LY96 (MD2) receptor complex on granulosa cells, leading to lower aromatase expression and reduced estradiol secretion. If cows with uterine disease ovulate, the peripheral plasma concentrations of progesterone are lower than those in normal animals. However, luteal phases are often extended in animals with uterine disease, probably because infection switches the endometrial epithelial secretion of prostaglandins from the F series to the E series by a phospholipase A2-mediated mechanism, which would disrupt luteolysis. The regulation of endometrial immunity depends on steroid hormones, somatotrophins, and local regulatory proteins. Advances in knowledge about infection and immunity in the female genital tract should be exploited to develop new therapeutics for uterine disease.

The effect of Escherichia coli lipopolysaccharide and tumour necrosis factor alpha on ovarian function

PROBLEM

Pelvic inflammatory disease and metritis are important causes of infertility in humans and domestic animals. Uterine infection with Escherichia coli in cattle is associated with reduced ovarian follicle growth and decreased estradiol secretion. We hypothesized that this effect could be mediated by the bacterial lipopolysaccharide (LPS) or cytokines such as tumour necrosis factor alpha (TNFalpha).

METHOD OF STUDY

In vitro, bovine ovarian theca and granulosa cells were treated with LPS or TNFalpha and steroid secretion measured. In vivo, the effect of LPS or TNFalpha intrauterine infusion was determined by ovarian ultrasonography and measurement of hormones in cattle.

RESULTS

Lipopolysaccharide reduced granulosa cell estradiol secretion, whilst TNFalpha decreased theca and granulosa cell androstenedione and estradiol production, respectively. In vivo, fewer animals ovulated following intrauterine infusion with LPS or TNFalpha.

CONCLUSION

Lipopolysaccharide and TNFalpha suppress ovarian cell function, supporting the concept that pelvic inflammatory disease and metritis are detrimental for bovine ovarian health.

The roles of PGF(2alpha) and PGE(2) in regression of the corpus luteum after intrauterine infusion of Arcanobacterium pyogenes in cows

To study the effect of bacteria in the uterus on the fate of the corpus luteum (CL), Arcanobacterium pyogenes was inoculated into the uteri of cows on Day 3 (Day 0=day of spontaneous ovulation). Plasma concentrations of 13,14-dihydro-15-keto-PGF(2alpha) (PGFM), 13,14-dihydro-15-keto-PGE(2) (PGEM) and progesterone (P(4)) were determined. In five cows, the developing CL regressed and first-wave dominant follicles, which normally become atretic, ovulated (Group OV) after bacterial inoculation. In another five cows (Group NOV) and five control cows, the developing CL did not regress and first-wave dominant follicles did not ovulate. In Group OV, PGFM concentrations increased by 126.2pg/mL (from 36.8+/-7.8pg/mL on Day 3 to 163+/-37.2pg/mL on Day 6), with an increase ratio of 5.8-fold. Conversely, in Group NOV, PGFM had a greater increase of 198.4pg/mL (from 128.2+/-27.8pg/mL on Day 3 to 326.6+/-115.1pg/mL on Day 5), but the increase ratio was only 2.3-fold. Although PGEM tended to increase in both groups, raw increases and increase ratios were small. Bacterial inoculation into the uterus stimulated the release of prostaglandins and affected the fate of the CL; in that regard, the CL was affected more by PGF(2alpha) than by PGE(2), and the increase ratio of PGF(2alpha) was more important than the raw increase.

Blood COX-2 and PGES gene transcription during the peripartum period of dairy cows with normal puerperium or with uterine infection

In the dairy cow, puerperal uterine intra-luminal concentrations of PGE(2) are related to the establishment and severity of uterine infections. Here we evaluated whether the blood concentrations of PGE(2) and the gene transcription profiles of enzymes involved in its synthesis (cyclooxygenase-2 and prostaglandin E synthase) could be used as markers of predisposition and/or presence of puerperal uterine infections. We also studied the relationship between the endocrine status and the leukocyte profiles around parturition and the transcription patterns of the genes. Finally, we have characterized the in vitro gene transcription and expression response to a challenge of LPS. Gene transcription profiles, quantified by real-time PCR, were similar in normal puerperium and metritis/endometritis cows, indicating that they are not suitable markers of predisposition to/presence of puerperal uterine infections. Transcription decreased from 2 weeks before parturition until parturition, when a minimum was attained, and then increased during the first week postpartum. The lowest gene transcription, at parturition, was coincidental with the highest total leukocytes, polymorphonuclear neutrophils and CD14 positive cell numbers. It is suggested that by this mechanism, a large number of PMN can be recruited into the uterus after parturition, avoiding an excessive acute inflammatory response. The lowest gene transcription was also coincidental with the surge in cortisol concentrations, indicating that this hormone plays a main immunomodulatory role around parturition. Gene transcription was significantly greater after stimulation with LPS than in non-stimulated blood. We suggest that this PGE(2) producing cells might arrive to the uterine lumen, contributing to the local PGE(2) concentrations and mediating the inflammatory response.

The immune status of the bovine uterus during the peripartum period

The post-partum period in cattle is characterised by an increased risk of infection of the uterus, as the anatomical barriers are broached during parturition and remain open for several days. Infection of the uterus is largely influenced by the balance between bacterial contamination and the local and systemic immune status during pregnancy and around parturition. Infectious diseases are more prevalent during this period, because of an impaired immune status before and immediately after parturition. Neutrophils play a primary role in the defence of the uterus against infection. Influx of neutrophils into the uterus is thought to be mediated by chemoattractants, chemokines and adhesion molecules, such as beta2-integrin (complement receptor 3) and L-selectin (CD62L). Other cellular components activated in the uterus during this period include lymphocytes, eosinophils, mast cells and macrophages. The major classes of immunoglobulins (IgM, IgA and IgG), either by passive diffusion or local production, play an important protective role in the uterus by acting as opsonins to enhance phagocytosis, stimulating the complement pathways or blocking pathogens from adhering to mucosal surfaces. Endometrial cells express toll-like receptor 4 (TLR4), which recognises lipopolysaccharides of Escherichia coli and other Gram negative bacteria, the most common causes of bovine endometritis. Activation of TLR4 triggers the production of tumour necrosis factor alpha and other pro-inflammatory cytokines. The periparturient period is also characterised by an increased secretion of prostaglandin F(2alpha), which enhances uterine immune defences.