High concentrations of Myeloperoxidase in the equine uterus as an indicator of endometritis

Intra-luminal fluid and excessive abnormal hyper-edema are regularly used for the diagnosis of endometritis in the mare, which is routinely confirmed by the presence of neutrophils on endometrial smears. Studies show a relation between neutrophils and myeloperoxidase (MPO), an enzyme contained in and released by neutrophils during degranulation or after cell lysis. This enzyme has been found in many fluids and tissues and associated with different inflammatory pathologies in the horse.
The aims of this study were to assess the presence and concentration of MPO in the equine uterus, and to investigate its relation with neutrophils, and other clinical signs of endometritis. Mares (n=51) were evaluated for presence of intra-luminal fluid and excessive endometrial edema before breeding, and a small volume lavage and cytology samples were obtained. From 69 cycles, supernatant of the uterine flushes was analysed with a specific equine MPO ELISA assay to measure MPO concentration. Cytology samples were used for the diagnosis of endometritis.
MPO was present in the uterus of all estrus mares in highly variable concentrations. MPO concentrations were significantly (p<0.05) higher in samples with positive cytologies and in presence of intra-luminal fluid. Occasionally, some samples with negative cytologies showed high MPO concentration, but the opposite was never observed. Cycles presenting hyper-edema weren’t associated to high concentration of MPO, intra-luminal fluid or positive cytology making it a poor diagnostic tool of endometritis.