The Effects of Treatment with N-Acetyl Cysteine on Clinical Signs in Persistent Breeding-Induced Endometritis Susceptible Mares.
Abstract: Persistent breeding-induced endometritis (PBIE) is a major cause of infertility in mares. Endometrial inflammation that persists until embryonic descent ultimately results in early embryonic death. A poor endometrial biopsy grade (IIb or III) has been identified as a risk factor for PBIE. Intrauterine fluid accumulation (>2 cm in depth), pathologic endometrial edema, and elevated intrauterine neutrophil levels are all clinical features of PBIE. Commonly applied treatment options include uterine lavage and oxytocin therapy. N-acetyl cysteine (NAC), a mucolytic used to treat bacterial endometritis in mares, has anti-inflammatory properties and was investigated as a potential treatment for PBIE. A randomized, blinded, cross-over design clinical trial used NAC before breeding in PBIE-susceptible mares (n = 9). Intrauterine infusion of 3.3% NAC was performed 12 hours before insemination, and endometrial cytology and endometrial biopsy samples were obtained at 12 and 60 hours after insemination. Endometrial biopsies were evaluated for the degree of inflammation present. Clinical signs of endometrial edema and intrauterine fluid volumes were assessed by transrectal ultrasound at 12 and then every 24 hours after breeding. Data were analyzed using repeated measures analysis of variance and a Mann Whitney Wilcoxon Test. Treatment with NAC did not improve clinical signs in PBIE-affected mares. However, endometrial biopsies from mares treated with NAC displayed more diffuse and severe neutrophil infiltration than control cycles. Further research using a larger population of mares is required to evaluate the effects of NAC treatment on the endometrium of PBIE-susceptible mares.
Crown Copyright © 2020. Published by Elsevier Inc. All rights reserved.
Publication Date: 2020-05-30 PubMed ID: 32797774DOI: 10.1016/j.jevs.2020.103142Google Scholar: Lookup
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- Journal Article
- Randomized Controlled Trial
- Veterinary
- Research Support
- Non-U.S. Gov't
Summary
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This research investigates the effect of N-acetyl cysteine (NAC) treatment on clinical symptoms in mares prone to persistent breeding-induced endometritis (PBIE), a common cause of infertility. Although the study didn’t find NAC to improve clinical signs, it observed wider and more severe neutrophil infiltration in endometrial biopsies after NAC treatment, suggesting a need for further research.
Research Context
- Persistent breeding-induced endometritis (PBIE) is a prevalent issue causing infertility in mares. In PBIE, endometrial inflammation continues until embryonic descent, resulting in early embryonic death. Fertility complications arise due to poor endometrial biopsy grades (IIb or III), which are potential risk factors for PBIE.
- Clinical manifestations of PBIE include fluid accumulation in the uterus, abnormal endometrial edema, and high intrauterine neutrophil levels. Standard treatments primarily involve uterine lavage and oxytocin therapy.
Research Objective
- The study aims to explore the effects of N-acetyl cysteine (NAC) on PBIE. NAC, a mucolytic usually employed to address bacterial endometritis in mares, was chosen due to its anti-inflammatory properties.
Research Methodology
- A randomised, blinded, cross-over design clinical trial comprising PBIE-prone mares (n = 9) was conducted. The NAC treatment was given 12 hours prior to insemination.
- Endometrial cytology and biopsy samples were collected at 12 and 60 hours post insemination, then examined for inflammation. Transrectal ultrasound was used at 12 hours and every 24 hours post breeding to evaluate endometrial edema and intrauterine fluid volumes.
- The data obtained was analysed using repeated measures analysis of variance and the Mann Whitney Wilcoxon Test.
Results and Future Directions
- NAC treatment didn’t appear to improve the clinical signs in affected mares. However, increased diffuse and severe neutrophil infiltration was noted in endometrial biopsies taken from NAC treated mares.
- These results indicate that NAC may have an unstudied effect on inflamation in the endometrium of mares susceptible to PBIE, despite no observable clinical improvement. The study, therefore, suggests further research on a larger population to conclusively analyse the effects of NAC treatment on the endometrium of PBIE-susceptible mares.
Cite This Article
APA
Caissie MD, Gartley CJ, Scholtz EL, Hewson J, Johnson R, Chenier T.
(2020).
The Effects of Treatment with N-Acetyl Cysteine on Clinical Signs in Persistent Breeding-Induced Endometritis Susceptible Mares.
J Equine Vet Sci, 92, 103142.
https://doi.org/10.1016/j.jevs.2020.103142 Publication
Researcher Affiliations
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada. Electronic address: mdcaissie@upei.ca.
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
- Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
- Department of Biomedical Sciences, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
- Department of Population Medicine, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.
MeSH Terms
- Acetylcysteine / therapeutic use
- Animals
- Disease Susceptibility / veterinary
- Endometritis / drug therapy
- Endometritis / veterinary
- Endometrium
- Female
- Horse Diseases / drug therapy
- Horses
Citations
This article has been cited 2 times.- Petkova T, Rusenova N, Danova S, Milanova A. Effect of N-Acetyl-L-cysteine on Activity of Doxycycline against Biofilm-Forming Bacterial Strains. Antibiotics (Basel) 2023 Jul 14;12(7).
- Ninković M, Žutić J, Tasić A, Arsić S, Bojkovski J, Zdravković N. An Innovative Approach: The Usage of N-Acetylcysteine in the Therapy of Pneumonia in Neonatal Calves. Animals (Basel) 2024 Oct 3;14(19).
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