Zika Virus Causes Acute Infection and Inflammation in the Ovary of Mice Without Apparent Defects in Fertility

BACKGROUND

Zika virus (ZIKV) has become a global concern because infection of pregnant mothers was linked to congenital birth defects. Zika virus is unique from other flaviviruses, because it is transmitted vertically and sexually in addition to by mosquito vectors. Prior studies in mice, nonhuman primates, and humans have shown that ZIKV targets the testis in males, resulting in persistent infection and oligospermia. However, its effects on the corresponding female gonads have not been evaluated.

METHODS

In this study, we assessed the effects of ZIKV on the ovary in nonpregnant mice.

RESULTS

During the acute phase, ZIKV productively infected the ovary causing accumulation of CD4+ and virus-specific CD8+ T cells. T cells protected against ZIKV infection in the ovary, as higher viral burden was measured in CD8-/- and TCRβδ-/- mice. Increased cell death and tissue inflammation in the ovary was observed during the acute phase of infection, but this normalized over time.

CONCLUSIONS

In contrast to that observed with males, minimal persistence and no long-term consequences of ZIKV infection on ovarian follicular reserve or fertility were demonstrated in this model. Thus, although ZIKV replicates in cells of the ovary and causes acute oophoritis, there is rapid resolution and no long-term effects on fertility, at least in mice.

[THE FREQUENCY OF FACTORS CONTRIBUTING TO THE FORMATION OF ADHESIONS IN THE ABDOMINAL CAVITY IN WOMEN]

To determine the major factor that contributed to the formation of adhesions in the abdominal cavity in women with a history of surgical interventions, examined 86 women with adhesive disease (main group) in the past have suffered various surgeries. The average age of patients was 35,7±5,6 years. Clinical examination of patients included a collection of complaints, anamnesis of disease and life, physical examination. The degree of adhesion process in the abdominal cavity was evaluated according to the classification of the American Fertility Society (R-AFS, 1985) and the macroscopic scale proposed by N.I. Ayushinova and co-authors. I severity of adhesions was detected in 32 (37.2%) II stage - in 13 (15.1%), grade III - 14 (16.3%) and IV degree in 27 (31.4%) patients. The duration of the adhesive process averaged 6.3±0.6 years. Adhesions lasting 1-3 years met in 43.0% of cases, 4-5 years - in 31.4% of cases and more than 5 years - in 25.6% of cases. The reason for the formation of adhesions served as inflammatory diseases - at 39.5%, gynecological surgeries - in 32.7% of patients, appendectomy - 20.9%, surgery for acute intestinal obstruction - in 5.8% of patients. After laparotomy adhesions of grade III-IV were formed in 62.5% after laparoscopy - in 33.0% of cases, ie, in 1,9 times less (p <0,05). Adhesions in the abdominal cavity occurs in 39.5% of patients after salpingoophoritis and sexually transmitted infections, as well as in 32.7% women undergoing gynecological surgery. In 32.0% of patients with salpingoophoritis and 44.4% of STIs, there is a III-IV degree of adhesion. The frequency of high adhesion after laparotomy is 62.5%, after laparoscopy - 33.3%.

[Spontaneous renal forniceal rupture with suspicious ovarian mass]

Extravasation of urine following rupture of the renal fornix is a rare complication mostly caused by obstruction secondary to distal ureteric stones. This 35-year-old woman was referred with back pain. Her CT scan revealed rupture of the renal fornix secondary to a pelvic mass. Laparoscopy subsequently confirmed this to be an ovarian abscess. We report the first case of spontaneous renal forniceal rupture secondary to pelvic inflammatory disease.

[Clinical, epidemiological, and pathogenetic aspects of formation of persisting forms of high oncogenic risk papillomavirus infection in women]

AIM

To reveal factors related with presence of human papillomavirus in women.

MATERIALS AND METHODS

Nine hundred and fifty women of childbearing age from 18 to 45 years old (30 of them--almost healthy) were examined. Samples of epithelium of urogenital tract obtained by scrapings were tested for the presence of urogenital infections by real-time polymerase chain reaction. Colposcopy, cytologic study, and ultrasound examination of pelvic organs were conducted.

RESULTS

Human papillomaviruses types 16 and 18 were detected in 41% of studied women. Of them, persisting form of papillomavirus infection was identified in 38%. Following factors promoted the development of persisting papillomavirus infection in women: age under 21 years, presence of pelvic inflammatory disease (endometritis, salpingoophoritis), cervical ectopy, use of untrauterine devices, oncologic diseases in family history, and presence of pointed condylomas. Signs specific for chronic inflammatory disease of cervix were observed significantly more frequently in women with persisting papillomavirus infection.

CONCLUSION

Association between presence of chronic inflammatory diseases of female reproductive system, related with different adverse factors, and persistence of human papillomavirus of high oncogenic risk in women.

[Interference therapy in combined treatment of patients with chronic nonspecific salpingoophoritis]

Neurotropic interference therapy (NIT) was studied as monotherapy and in combination with iodine-bromide water in 50 patients with chronic nonspecific salpingoophoritis. NIT was found effective in the above disease as it improved clinical picture, reproductive function, psychoemotional condition of the patients. The addition of iodine-bromide water to NIT potentiates and prolongs neurotropic, endocrine, analgetic and anti-inflammatory effects of NIT.

[Acute salpingoophoritis: early intensive UHF-therapy]

The placebo-controlled trial of effectiveness of early intensive UHF therapy in 107 females at reproductive age with acute salpin-goophoritis has demonstrated high clinical and local immunomodulating effects of intensive UHF therapy (460 MHz, 3 procedures a day) in combination with adequate antibacterial treatment used as early as hospitalization day 1.

[Functional activity of phagocytizing cells of the female reproductive tract in inflammation of the upper part of genitalia]

66 women of reproductive age with different course of the inflammatory process in the upper section of the reproductive tract (endometritis and salpingo-oophoritis) were examined. The cell composition, viability and functional activity of the phagocytizing cells of cervical and endometrial secretions, as well as peritoneal exudate, were studied. The study revealed that these characteristics of the phagocytizing cells of the reproductive tract in women with the inflammatory process differed from similar characteristics in healthy women. Different changes in the functional activity of neutrophils and macrophages in the biological fluids under study in different course of the inflammatory process were detected.

[Characteristics of enterobacteria isolated from patients with urogenital pathology]

Species composition and a number of persistence characteristics enterobacteria isolated from urine of 42 pregnant and 22 nonpregnant women with pyelonephritis (relapse, remission), from prostatic fluid of 225 males and secretions of cervical canal of 124 women with urogenital pathology (prostatitis, salpingo-oophoritis) were studied. The study revealed that enterobacteria, including Escherichia coli, prevailed in the structure of uromicroflora (66.7-83.3%) and constituted a relatively small proportion among "genital" isolates of microorganisms (19.9-22.2%). Male and female sterility and the presence of enterobacteria in the reproductive tract of patients were found to be directly correlated. Clinical isolates of enterobacteria were shown to possess pronounced seroresistance and the complex of persistence characteristics, including antilysozyme, anti-intercidal and anticomplementary activity.

Xanthogranulomatous salpingitis and oophoritis: a case report and review of the literature

A case of xanthogranulomatous salpingitis and oophoritis in a 47-year-old woman is presented. Xanthogranulomatous inflammation is an uncommon form of chronic inflammation that is destructive to affected organs; it is characterized by the presence of lipid-filled macrophages with admixed lymphocytes, plasma cells, and neutrophils. Only a few cases of xanthogranulomatous salpingitis and oophoritis have been reported to date. The case presented here is associated with Escherichia coli infection, endometriosis, and an intrauterine device.

Silent oophoritis due to cytomegalovirus in a patient with advanced HIV disease

A case of isolated necrotizing cytomegalovirus (CMV) oophoritis disclosed only by necropsy studies in a patient with AIDS, is described. This unusual case report is discussed with a review of the literature dealing with CMV involvement of genital organs in the immunocompromised host, and in patients with HIV infection and AIDS.

Infertility due to abnormalities of the ovaries in cattle

A careful physical examination of a cow or heifer suspected of having an ovarian problem often results in a specific diagnosis (e.g., freemartinism) or a workable list of differentials. When the diagnosis is uncertain, techniques such as rapid progesterone assays, ultrasonographic imaging, ova or embryo recovery, and cytogenetic evaluation can provide critical information for a well-based diagnosis and prognosis. Despite the wide array of problems that can afflict the bovine ovary, cystic ovaries probably are the most commonly diagnosed and treated ovarian abnormality. Cysts have a variable life span and sometimes occurs together with a CL. Hormonal therapy with either GnRH followed by PG approximately 9 to 14 days later, or GnRH alone, followed by good heat detection is the treatment of choice for cows with cysts. Other conditions associated with ovarian dyfunction and infertility include adhesions, developmental anomalies, and tumors. The life span of a CL in the cow can be shortened unintentionally by attempting to correct other problems (e.g., multiple injections of oxytocin for milk let-down), or lengthened by uterine pathology (e.g., pyometra, or uterus unicornis). The administration of GnRH or hCG to improve ovarian function and pregnancy rates in cows may be beneficial in selected herds.

Autoimmune oophoritis. An incidental finding

A case of autoimmune oophoritis is reported. A 41-year-old woman had a total abdominal hysterectomy and bilateral salpingo-oophorectomy for menorrhagia, polymenorrhoea and cystic ovaries. The diagnosis of autoimmune oophoritis was not suspected clinically, and was an unexpected histological finding in the ovaries. The gross and histological appearances of this rare condition are described, and the lymphoid infiltrate characterised by immunocytochemistry. Recognition of this condition by pathologists is important, as there is an associated risk of developing other autoimmune disease, even some years later, necessitating close patient follow-up. In this case serum auto-antibodies to adrenal cortex were detected, indicating a subsequent risk of Addison's disease.

[Treatment of endometritis and salpingo-oophoritis monitored by the antilysozyme activity of the agents]

The authors suggest new methods for the choice of drugs and physiotherapeutic modalities for the treatment of female genital inflammations, based on the suppression of the agents' antilysozymic activities, factors of the agent intracellular persistence. Clinical trials of these methods in 91 patients have shown their high efficacy: the incidence of complete remissions has increased by 60.7%, incidence of disease recurrences reduced by 53%, and remission periods in chronic patients were prolonged by 2.5-3 times (from 0.5-1 year to 2.5-3 years).

[Acupuncture therapy in the comprehensive treatment of salpingo- oophoritis]

Follow-up and therapy of 136 patients with nonspecific salpingo-oophoritis evidence the efficacy of acupuncture included in a complex of therapeutic measures for the treatment of this condition, as compared to traditional therapeutic modalities. Acupuncture therapy is conductive to shortening in-hospital therapy, to full-value normalization of the body immunobiologic defense and of the autonomic nervous system, and to a reduction of the incidence of the condition recurrences.

Clinical approach to infertility in bitches with primary anestrus

In conclusion, a complete workup of the bitch that has not shown a puberal estrus by 24 months of age should include a general screen with hemogram, chemistries profile and urinalysis, karyotype, serum thyroid hormone profile, serum progesterone concentration, and serum luteinizing hormone concentration, if available. If the results of these tests are normal, an exclusion diagnosis of immune-mediated oophoritis, which can be confirmed by ovarian biopsy, should be considered. Bitches with primary anestrus secondary to thyroid insufficiency or chronic debilitating disease may show normal reproductive cycling and performance after successful treatment of these disorders; in other patients, prognosis for future reproduction is poor.

[Evaluation of functional activity of the complement system in differential diagnosis of chronic salpingo-oophoritis]

Nonspecific and selected determinants of humoral immunity have been evaluated in 122 patients who clinically presented with "chronic salpingo-oophoritis". An objective confirmatory study is laparoscopy. The patients with clinical presentations of chronic salpingo-oophoritis displayed depressed phagocytic activity of neutrophils and function of complement in its both pathways. Alternatively, humoral immune parameters (serum levels of immunoglobulins A, M, G and circulating immune complexes) were normal. Functional evaluation of the classical and alternative complement activation pathways may provide a noninvasive objective test for differential diagnosis of chronic salpingo-oophoritis.

Cystic ovarian enlargement resulting from autoimmune oophoritis

Autoimmune oophoritis is a rare cause of premature ovarian failure. Previous studies of autoimmune oophoritis have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have detailed the clinical, immunologic, and histologic findings. The gross pathologic features of the involved ovaries have not been emphasized. Herein, we describe a 35-year-old woman with autoimmune oophoritis who presented with symptoms referable to a right cystic adnexal mass. She underwent a diagnostic laparotomy and right salpingo-oophorectomy for removal of an 8.0-cm-diameter, twisted multicystic ovary. Microscopically, mononuclear inflammatory cells infiltrated multiple follicular and luteal cysts. We have seen two additional patients with histologically verified autoimmune oophoritis who underwent diagnostic laparotomy and oophorectomy because of cystic enlargement of the ovaries. Stimulation of ovarian follicles by elevated levels of pituitary gonadotropins probably causes the cystic changes. Recognition of this aspect of autoimmune oophoritis may help to prevent oophorectomy in patients whose functioning ovarian tissue is already compromised by autoimmune destruction.

Ureteral obstruction and hydronephrosis as a complication of tuboovarian abscess. A case report

Ureteral obstruction and hydronephrosis are rare complications of pelvic inflammatory disease. A woman developed severe unilateral urinary tract obstruction caused by a tuboovarian abscess, requiring ureteral stent placement.

Lymphocyte dysfunction in autoimmune oophoritis. Resumption of menses with corticosteroids

In a 32-year-old woman with secondary amenorrhea and biopsy-proven oophoritis, the circulating T lymphocytes were examined utilizing monoclonal antibody L243 to the nonpolymorphic region of the Ia antigen. The percentage of peripheral T cells expressing the Ia "immune-associated' antigen was 5.6 percent (normal 3 percent or less). With corticosteroid therapy, the percentage decreased to 2 percent and menses resumed after secondary amenorrhea of two years' duration. Following cessation of steroid administration, the percentage of Ia-positive T cells rose to 7.0 percent and secondary amenorrhea redeveloped in the patient. After corticosteroid therapy was reinstituted, menses resumed and the percentage of Ia-positive T cells fell to normal. This report represents additional new evidence of immune dysfunction in patients with "autoimmune" oophoritis.

Bilateral salpingitis, hydrosalpinx and oophoritis in a mare

Bilateral salpingitis, hydrosalpinx and oophoritis were diagnosed in a mare with concurrent lymphosarcoma. Salpingitis, hydrosalpinx and oophoritis are rare in the mare (1,2,3,5,8,9,11-13). Bilateral salpingitis is an important cause of infertility in all species and is most often due to ascending infection (3-5,10,11). The source of salpingitis in this mare probably was ascending infection from the uterus after parturition. The apparent infertility of the mare was attributed to debilitation from the lymphosarcoma and multiplicity of genital pathoses.

Postpartum perforation of the colon due to endometriosis

A case is reported of a ruptured endometriotic lesion following childbirth. Immediately after her second delivery, the 34-year-old parturient developed acute abdominal pain. At operation a ruptured left-sided ovarian abscess with a fistula to the colon was found. Endometriosis was present in the ovarian wall and the adjacent colon. Endometriosis as a cause of acute abdominal pain during pregnancy should be kept in mind.

Bilateral enterobius vermicularis salpingo-oophoritis

Inflammatory pelvic disease secondary to infection with Enterobius vermicularis is rare in that pinworms are usually asymptomatic inhabitants of the terminal small bowel and cecum. When these parasites do cause symptoms, however, there is a spectrum of gastrointestinal and genitourinary complaints. A case is presented of a woman with bilateral abdominal pain that was found to be due to a combination of parasitic and bacterial (Bacteroides fragilis) infection. The parasitic fallopian tube infection may have predisposed the fallopian tubes to a microbial tuboovarian abscess.

Chronic salpingo-oöphoritis with hydrosalpinx formation and ureteric obstruction: A case report

An association between gynaecological lesions and dilatation of the upper urinary tract has frequently been described. Hydronephrosis as a result of pelvic inflammatory disease has, however, rarely been reported in the literature. The case presented here illustrates the importance of investigation by means of excretory urography in patients with pelvic inflammatory disease presenting with renal symptoms and signs.

Gonadal dysgenesis variants in sisters: a hitherto undescribed combination

The term "gonadal dysgenesis" covers a wide spectrum. This case report concerns two sisters with secondary amenorrhea who underwent systematic investigations, including karyotype analysis, tests for serum gonadotropins and laparoscopic gonadal biopsy. The diagnosis in each revealed a combination hitherto underscribed.