Uterine inflammation and lessons from large animal models of endometritis

Uterine inflammation encompasses several conditions, including endometritis, which is a local innate immune response, usually to bacteria. Endometritis is an important veterinary and medical problem that can result in infertility and/or recurrent pregnancy loss. This Review aims to summarize animal models that can be used to uncover the immune pathways responsible for uterine inflammation and their value for screening novel, putative therapies. We discuss large animal models of endometritis, particularly the well-used bovine system and the value that may be added by further developing porcine systems. Animal cells and tissue explants can be ethically sourced, and these models can replace or reduce the need for live animal studies and overcome the practical issues of harvesting endometrial material from women. We explain how these models of endometritis show great potential for advancing our understanding of the immune dysfunction underlying susceptibility to the condition, and for early-stage drug discovery.