Objective — to investigate the impact of intrauterine irrigations with a cavitated interferon-gamma solution on endometrial morphological characteristics, on the level of cytokine-producing cells and pro-inflammatory mediators and on the contents of human papillomaviruses and herpes simplex virus type 2 in the endometrial stroma of women with viral endometritis. Subject and methods. Morphological, immunological, and immunohistochemical examinations were conducted in 60 women with viral endometritis. Of them, 30 patients received combination treatment, including irrigation of the uterine cavity with an ultrasound-cavitated recombinant interferon-gamma solution, and 30 patients had standard therapy. Results. The preoperative immune system of viral endometriosis patients is characterized by inflammatory cellular reactions manifested as elevated spontaneous T lymphocyte levels, as significantly increased CD3+IL-4+ cell contents during stimulation, as a lower polarization index of induced cytokine-producing cells, as decreased serum IFN-γ levels, and as increased production of serum proinflammatory mediators. There was a reduction in the intracellular production of IL-4 T-lymphocytes and a shift of the cytokine balance towards a Th-1-dependent immune response at the local level. Conclusion. Combination therapy for women with chronic viral endometritis contributes to endometrial decontamination with human papillomaviruses and herpes simplex type 2, and increases the polarization index of induced cytokine-producing lymphocytes at the system level and shows a reduction in the percentage of induced CD3+IFN-γ+ cells during stimulation and a shift of the polarization index towards regulatory cytokine-producing cells at the local level. Irrigation of the uterine cavity with an ultrasound-cavitated interferon-gamma solution in patients with viral endometritis is an effective technology that influences the recovery of functional activity of immunocompetent cells of the endometrium, which can be used to prepare patients with uterine factor infertility for assisted reproductive technologies.
