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Article

Renin–Angiotensin–Aldosterone Axis Activity in Women with Chronic Endometritis: A Prospective Observational Study

by
Giulia Garbin
1,†,
Loris Marin
1,†,
Chiara Sabbadin
2,
Giuseppe Gullo
3,
Decio Armanini
2,4,*,
Luciana Bordin
1,*,
Eugenio Ragazzi
4,
Guido Ambrosini
1 and
Alessandra Andrisani
1
1
Department of Women’s and Children’s Health, University of Padova, 35128 Padova, Italy
2
Endocrine Unit, Department of Medicine DIMED, University of Padova, 35128 Padova, Italy
3
Department of Obstetrics and Gynecology, Villa Sofia Cervello Hospital, University of Palermo, 90146 Palermo, Italy
4
Studium Patavinum, University of Padova, 35122 Padova, Italy
*
Authors to whom correspondence should be addressed.
†
These authors contributed equally to this work.
Int. J. Mol. Sci. 2026, 27(18), 8256; https://doi.org/10.3390/ijms27188256 (registering DOI)
Submission received: 31 August 2026 / Revised: 14 September 2026 / Accepted: 15 September 2026 / Published: 16 September 2026
(This article belongs to the Collection Feature Papers in Molecular Pathology, Diagnostics, and Therapeutics)
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Abstract

Chronic endometritis (CE) is a persistent inflammatory disorder of the endometrium that is histopathologically characterized by CD138-positive plasma cells within the endometrial stroma. This study evaluated components of the renin–angiotensin–aldosterone system (RAAS) and interleukin-6 (IL-6) in infertile women with CE. Thirty-nine infertile women undergoing diagnostic hysteroscopy with endometrial biopsy were included. A total of 21 women were classified as CE-positive and 18 as CE-negative. Fasting blood samples were collected 48 h before hysteroscopy (t1) and approximately 2.5 h before the procedure (t2) to assess plasma renin, serum aldosterone, the aldosterone-to-renin ratio (ARR), sodium, potassium, progesterone, thyroid-stimulating hormone (TSH), and IL-6. Exploratory analyses were performed according to the extent of CD138-positive plasma-cell infiltration (plasma-cell burden, stratified as <20 or ≥20 cells/high-power field) and persistence versus resolution of CE after antibiotic treatment. Baseline characteristics, including body mass index (BMI), infertility duration, and anti-Müllerian hormone (AMH), were comparable between groups. No significant differences in the parameters were observed between CE-positive and CE-negative women. No consistent RAAS or inflammatory differences emerged according to plasma-cell burden or CE persistence after treatment. These findings suggest that CE is not associated with measurable systemic RAAS activation or IL-6 changes, supporting the hypothesis of local CE alterations.
Keywords: chronic endometritis (CE); renin–angiotensin–aldosterone system (RAAS); aldosterone; mineralocorticoid receptor (MR); CD138; infertility chronic endometritis (CE); renin–angiotensin–aldosterone system (RAAS); aldosterone; mineralocorticoid receptor (MR); CD138; infertility

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MDPI and ACS Style

Garbin, G.; Marin, L.; Sabbadin, C.; Gullo, G.; Armanini, D.; Bordin, L.; Ragazzi, E.; Ambrosini, G.; Andrisani, A. Renin–Angiotensin–Aldosterone Axis Activity in Women with Chronic Endometritis: A Prospective Observational Study. Int. J. Mol. Sci. 2026, 27, 8256. https://doi.org/10.3390/ijms27188256

AMA Style

Garbin G, Marin L, Sabbadin C, Gullo G, Armanini D, Bordin L, Ragazzi E, Ambrosini G, Andrisani A. Renin–Angiotensin–Aldosterone Axis Activity in Women with Chronic Endometritis: A Prospective Observational Study. International Journal of Molecular Sciences. 2026; 27(18):8256. https://doi.org/10.3390/ijms27188256

Chicago/Turabian Style

Garbin, Giulia, Loris Marin, Chiara Sabbadin, Giuseppe Gullo, Decio Armanini, Luciana Bordin, Eugenio Ragazzi, Guido Ambrosini, and Alessandra Andrisani. 2026. "Renin–Angiotensin–Aldosterone Axis Activity in Women with Chronic Endometritis: A Prospective Observational Study" International Journal of Molecular Sciences 27, no. 18: 8256. https://doi.org/10.3390/ijms27188256

APA Style

Garbin, G., Marin, L., Sabbadin, C., Gullo, G., Armanini, D., Bordin, L., Ragazzi, E., Ambrosini, G., & Andrisani, A. (2026). Renin–Angiotensin–Aldosterone Axis Activity in Women with Chronic Endometritis: A Prospective Observational Study. International Journal of Molecular Sciences, 27(18), 8256. https://doi.org/10.3390/ijms27188256

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