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Plasma Rico em Plaquetas no Tratamento de Éguas com Endometrite Persistente Pós-cobrição/Inseminação Artificial: Avaliação da Eficácia Clínica
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Abstract(s)
A endometrite persistente pós-cobrição/inseminação artificial tem uma etiologia multifatorial e afeta
uma grande proporção de éguas reprodutoras com historial de falhas reprodutivas. Sabe-se
atualmente que uma endometrite fisiológica e transitória ocorre em resposta à presença de
espermatozoides alogénicos, detritos celulares e imunológicos, bem como bactérias comensais ou
patogénicas, sem que, à primeira vista, a origem seja necessariamente infeciosa.
Distinguem-se duas populações de éguas reprodutoras quanto à sua capacidade de modular a resposta
inflamatória uterina de forma eficaz e atempada. As éguas consideradas resistentes conseguem, nas
primeiras 48 horas, reduzir a presença de neutrófilos, citoquinas pró-inflamatórias, bem como o
edema endometrial e o fluido intrauterino acumulado. Por outro lado, as éguas suscetíveis apresentam
um atraso na limpeza uterina, um desequilíbrio entre as citoquinas pró e anti-inflamatórias, e
acumulação de fluido e edema endometrial, criando um ambiente uterino desfavorável à migração e
implantação embrionária.
Embora as terapias convencionais mostrem eficácia em muitas éguas, algumas continuam a não
responder aos tratamentos. A resistência crescente e as limitações no uso de antibióticos sem testes
prévios impulsionam a procura de terapias alternativas seguras. O plasma rico em plaquetas, devido
às suas propriedades anti-inflamatórias, regenerativas e antimicrobianas, é uma alternativa
promissora. Pode ser administrado por via intrauterina, isoladamente ou como complemento aos
tratamentos convencionais, oferecendo uma nova abordagem para o tratamento da endometrite
persistente pós-cobrição/inseminação artificial.
São necessários estudos adicionais para otimizar e uniformizar os protocolos de preparação e
administração do PRP, tornando-o acessível à prática veterinária equina e viável para uso em larga
escala, bem como para avaliar a sua eficácia a longo prazo.
Persistent endometritis post-covering/artificial insemination has a multifactorial etiology and affects a large proportion of broodmares with a history of reproductive failure. It is currently known that a physiological and transient endometritis occurs in response to the presence of allogeneic spermatozoa, cellular and immunological debris, as well as commensal or pathogenic bacteria, without the origin necessarily being infectious at first glance. Two populations of broodmares are distinguished according to their ability to modulate the uterine inflammatory response effectively and in a timely manner. Mares considered resistant are able, within the first 48 hours, to reduce the presence of neutrophils, pro-inflammatory cytokines, as well as endometrial edema and accumulated intrauterine fluid. On the other hand, susceptible mares present a delay in uterine clearance, an imbalance between pro- and anti-inflammatory cytokines, and accumulation of fluid and endometrial oedema, creating a uterine environment unfavorable to embryonic migration and implantation. Although conventional therapies show efficacy in many mares, some continue to not respond to treatments. The growing resistance and limitations in the use of antibiotics without prior testing drive the search for safe alternative therapies. Platelet-rich plasma, due to its anti-inflammatory, regenerative, and antimicrobial properties, is a promising alternative. It can be administered by intrauterine infusion, either alone or as a complement to conventional treatments, offering a new approach to treating persistent endometritis post-covering/artificial insemination. Further studies are needed to optimize and standardize the preparation and administration protocols for PRP, making it accessible to equine veterinary practice and viable for large-scale use, as well as to evaluate its long-term efficacy.
Persistent endometritis post-covering/artificial insemination has a multifactorial etiology and affects a large proportion of broodmares with a history of reproductive failure. It is currently known that a physiological and transient endometritis occurs in response to the presence of allogeneic spermatozoa, cellular and immunological debris, as well as commensal or pathogenic bacteria, without the origin necessarily being infectious at first glance. Two populations of broodmares are distinguished according to their ability to modulate the uterine inflammatory response effectively and in a timely manner. Mares considered resistant are able, within the first 48 hours, to reduce the presence of neutrophils, pro-inflammatory cytokines, as well as endometrial edema and accumulated intrauterine fluid. On the other hand, susceptible mares present a delay in uterine clearance, an imbalance between pro- and anti-inflammatory cytokines, and accumulation of fluid and endometrial oedema, creating a uterine environment unfavorable to embryonic migration and implantation. Although conventional therapies show efficacy in many mares, some continue to not respond to treatments. The growing resistance and limitations in the use of antibiotics without prior testing drive the search for safe alternative therapies. Platelet-rich plasma, due to its anti-inflammatory, regenerative, and antimicrobial properties, is a promising alternative. It can be administered by intrauterine infusion, either alone or as a complement to conventional treatments, offering a new approach to treating persistent endometritis post-covering/artificial insemination. Further studies are needed to optimize and standardize the preparation and administration protocols for PRP, making it accessible to equine veterinary practice and viable for large-scale use, as well as to evaluate its long-term efficacy.
Description
Keywords
Éguas resistentes Endometrite Imunomodulação Infertilidade Plasma Rico em Plaquetas Terapia Alternativa Alternative Therapy Endometritis Immunomodulation Infertility Platelet Rich Plasma Resistant mares