Figure 9.

Proposed mechanism of the switch to pathological inflammation in endometritis. A physiological inflammatory response in the post-partum endometrium is characterized by a (mostly) intact epithelium, inflammasome activation in the epithelial cells with the majority of the subsequent release of the pro-inflammatory cytokine IL-1β directed into the uterine lumen. A pathological inflammatory immune response is characterized by a disrupted epithelium resulting in exposure of the stromal fibroblasts. Inflammasome activation subsequently occurs in the exposed stromal fibroblasts resulting in production of IL-1β and its release into both the lumen and surrounding endometrial tissue, propagating the pathological inflammation.