Angiogenesis-Related Factors in Early Pregnancy Loss

The habitual loss of early pregnancy is one of the major problems of obstetrics nowadays, provided that the cause of more than 50% of all early pregnancy losses is unknown. Adequate angiogenesis is one of the main indicators of proper formation of placental system, making the basis of fetal life support. The objective description of angiogenesis in physiological development of pregnancy and in pathological conditions is complicated by the difficulties in obtaining and characterizing placental tissue in early pregnancy. Thus, angiogenesis‐related factors are promising indicators to characterize angiogenesis in pregnancy. This chapter draws attention to alteration in angiogenesis‐related factors in peripheral blood of patients with habitual early pregnancy losses. Investigation of factors (vascular endothelial growth factor (VEGF), sFlt‐1, sKDR, metalloproteinase (MMP)‐2, MMP‐9, tissue inhibitor (TIMP)‐1, TIMP‐2 and placental growth factor (PLGF)), which specifically and nonspecifically regulate angiogenesis in pregnancy, was performed in the most significant terms for placentogenesis: 6 weeks, 7–8 weeks and 11–14 weeks of pregnancy. It was found that in a missed abortion there was a significant imbalance of angiogenesis‐related factors compared with normal pregnancy. These results reflect a disturbance of angiogenesis in a missed abortion and point to the importance of the studied factors in the pathogenesis of early pregnancy losses

Analysis of emergency situations associated with the risk of occupational infection of medical personnel

The aim of the study – to assess the structure of emergency situations associated with the risk of occupational infection of medical personnel in medical organizations of a large industrial region and to offer recommendations for their prevention (on the example of the Sverdlovsk region).Цель исследования – оценить структуру аварийных ситуаций, связанных с риском профессионального заражения медицинского персонала в медицинских организациях крупного промышленного региона и предложить рекомендации по их профилактике (на примере Свердловской области)

Epidemiological features of tuberculosis in the industrial megapolis of the Middle Urals

The aim of the study. To study the epidemiological features of the incidence of tuberculosis among the population in an industrial metropolis, using the example of Ekaterinburg, for 2011–2020.Цель исследования — изучить эпидемиологические особенности заболеваемости туберкулезом среди населения в промышленном мегаполисе на примере Екатеринбурга за 2011–2020 гг

Effect of immunocytotherapy on the state of the immune system of women with idiopathic habitual miscarriage

We aimed  for assessing effects of immunocytotherapy upon  the subpopulations of CD4+CD25highFoxP3+ cellswithnaturalregulatoryactivityandactivatedTh17cellswiththeCD4+CD25highRORγt+ phenotype, as well as in vitro production of cytokines in mitogen-stimulated cells from  peripheral blood  in the patients with idiopathic habitual miscarriage (IHM). The study group consisted of 33 patients with IHM who became pregnant after a pre-gestational alloimmunization. In 27 patients, the pregnancy was prolonged to the  full term  and  ended  with the  birth  of viable babies,  in six cases it was terminated before  12 weeks of gestation. Before  administration of immunocytotherapy (ICT), 19 patients were examined, of them  16 after alloimmunization outside of pregnancy, 17 at 5-6 and 8-9 weeks of pregnancy. Eleven patients were immunized at 12 weeks of pregnancy. In the control group,  12 fertile women  outside  pregnancy and 10 women  at 12 weeks of physiological pregnancy were examined. The proportion of FoxP3+ and RORγt+ cells with the CD4+CD25high phenotype was evaluated among  T-lymphocytes from peripheral blood,  as well as content of proinflammatory cytokines (IFNγ,  TNFα, IL-1β, IL-2, IL-5, IL  -6,  IL-8, IL-12p70) and  anti-inflammatory factors  (IL-4, IL-10), as well as IL-17  amounts.We have found  that,  following pre-gestational alloimmunization, the women  who lost this pregnancy, had a  low  level  of  FoxP3+Тregs that  suppress  pro-inflammatory Th17-dependent  reactions, however, without changing levels of activated Th17  cells (CD4+CD25highRORγt+   lymphocytes). These  facts,  along  with  high in vitro production of IL-17  by peripheral blood cells at the terms of 5-6 weeks of gestation, suggest that,  after pre-gestational alloimmunization in women  with miscarriage, a predilection is formed  to pro-inflammatory cytokine production. However, at the 5-6 week-period, it is realized  not in the Th1 direction of, but towards Th17 response, and a low level of CD4+CD25highRORγt+ cells may reflect an increased migration of Th17 cells from peripheral blood to the uterine endometrium.Thus,  we have shown  the  effect of immunocytotherapy upon  subpopulational composition of peripheral blood  lymphocytes and  the  cytokine profile,  as well as upon  the  course  of first trimester and  outcomes of pregnancy in women  with idiopathic habitual miscarriage

Profile of antiphospholipid antibodies and complement system in COVID-19 patients of different severity

COVID-19, a severe acute respiratory syndrome caused by SARS-CoV-2, may predispose to thrombotic events, especially when combined with antiphospholipid antibodies (aPL). However, there are limited data on prevalence and antigenic specificity of aPL in COVID-19. Complement activation is assumed to play an important role in pathogenesis of COVID-19-associated coagulopathy. During the SARS-CoV-2 pandemic, it is necessary to identify important biomarkers for predicting severe course of COVID-19 and risk of thrombotic complications. Our objective was to evaluate the aPL profile, quantitative content and activity of complement and its components in COVID-19 patients graded by severity in the course of time. IgM and IgG antibodies to cardiolipin (CL), phosphatidylserine (PS), β2-glycoprotein-I (β2-GP-I), prothrombin (PT), annexin V (An V), as well as C1q complement component, content of its C3 and C4 components and total complement activity were determined in blood serum using ELISA approach. 141 patients with COVID-19 were included in the study. Group 1 consisted of 39 patients with mild form, group 2 (65 patients) presented with moderate form, and group 3 included 37 patients with severe form of COVID-19. Blood samples were obtained on day 3-7 of the disease (1st point) and after 14-28 days (2nd point). The results were as follows: aPL were detected in 29.1% of the total COVID-19 cohort, frequency of aPL detection by the severity grade did not differ (33.3%, 24.6% and 32.4%). In 8.5% of the patients, aPL were detected only at the 1st time point; in 14.2%, only at the 2nd point; and in 6.4% of the cases, at the both time points. Antibodies to PT (16.3%) and An V (11.3%) were revealed more frequently. The detection frequency of antibodies to PT was significantly higher than antibodies to CL and PS (7.1%), β2-GP-I (7.8%). The prevalence of aPL in groups 1 and 3 did not differ. At the 1st point in group 3, increased levels of C4 (89.2%) and C3 (24.3%) in blood, and a decrease in complement activity (35.1%) were more often observed than in group 1. At the 2nd time point in group 3, a decrease in complement activity was often detected (59.5%). The C3 levels exceeding 720 μg/ml were found to predict a 2.6-fold increased risk of severe COVID-19, and this risk became 3.3 times higher at C4 levels of > 740 μg/ml. The antibodies to PT and An V are often detected in COVID-19 patients, along with low prevalence of antibodies to CL and β2-GP-I. These antibodies can be involved in pathogenesis of COVID-19-associated coagulopathy, being detectable at the late stage of the disease, and they may trigger APS in predisposed patients and reconvalescents. Although presence of aPL antibodies is not associated with COVID-19 severity, their persistence over the period of convalescence may be an additional risk factor for thromboembolic complications. The COVID-19 patients are characterized by activation of the complement system, which increases in severe cases, and manifests with increased or decreased levels of C3 complement component, increased levels of C4 component in blood, and a decreased total complement activity. Quantitative determination of C3 and C4 complement components over the period of COVID-19 progression is of prognostic value, with respect to severity of the disease

Effect of COVID-19 vaccination on the immune status and autoantibody profile in women of reproductive age

In the context of the COVID-19 pandemic, scientific interest is growing in studying the impact of the proposed vaccination on women’s reproductive health. As is known, alterations in the state of the immune system and activation of an autoimmune response can lead to reproductive failure in women and potential complications of subsequent pregnancy. Objective: to evaluate the effect of the “Gam-COVID-Vac” on the immune status parameters, the relationship of their changes and the specific immune response to vaccination with the dynamics of the level of autoantibodies in women of reproductive age.The prospective study included 120 women who were vaccinated against COVID-19 with the “Gam-COVIDVac”. The criteria for inclusion in the study were: the age from 18 to 49 years, the absence of COVID-19 in the anamnesis, a negative result of a study on SARS-CoV-2 by PCR and negative results of tests for antibodies of classes G and M to SARS-CoV-2 before vaccination, the absence of pregnancy and serious somatic diseases. The patients were examined twice: immediately before vaccination and 90-100 days after the introduction of the 1st component of the vaccine. The level of IgG antibodies to SARS-CoV-2 after vaccination was assessed using ELISA. Before and after vaccination, the levels of antiphospholipid, anti-nuclear, organ-specific and antihormonal autoantibodies were determined, peripheral blood lymphocytes were immunophenotyped to determine the main subpopulations (CD3, CD4, CD8, CD19, CD5, CD16, CD56), as well as the expression of activation markers of lymphocytes (HLA-DR, CD25, CD147) using monoclonal antibodies.The effectiveness and safety of the combined vector vaccine against COVID-19 were high. Specific IgG antibodies to SARS-CoV-2 were produced in 98.3% of vaccinated women, no serious adverse reactions were observed. After vaccination, there was an increase in the level of some autoantibodies within the reference ranges, only IgM antibodies to phosphatidylethanolamine (PE) and IgG antibodies to DNA increased above the reference values. However, this increase was transient. After vaccination, the following changes in the parameters of the immunogram were observed: an increase in the content of cells with CD3+CD25+, CD19+ phenotype in peripheral blood and a decrease in the content of cells with CD56+CD16+ phenotype within the reference ranges, a decrease in CD147+/CD3+. Weak correlations were noted between these changes in immunogram parameters and the levels of some autoantibodies. The specific antiviral immune response to vaccination did not correlate with the autoimmune response.Vaccination with “Gam-COVID-Vac” is effective and safe and does not lead to disorders in the immune system. The observed increase in the level of autoantibodies to PE and DNA is transient. Changes in the parameters of the immune status within the reference ranges may be due to vaccination and the development of a specific antiviral immune response

Epitope-Specific Response of Human Milk Immunoglobulins in COVID-19 Recovered Women

The breastfeeding of infants by mothers who are infected with SARS-CoV-2 has become a dramatic healthcare problem. The WHO recommends that infected women should not abandon breastfeeding; however, there is still the risk of contact transmission. Convalescent donor milk may provide a defense against the aforementioned issue and can eliminate the consequences of artificial feeding. Therefore, it is vital to characterize the epitope-specific immunological landscape of human milk from women who recovered from COVID-19. We carried out a comprehensive ELISA-based analysis of blood serum and human milk from maternity patients who had recovered from COVID-19 at different trimesters of pregnancy. It was found that patients predominantly contained SARS-CoV-2 N-protein-specific immunoglobulins and had manifested the antibodies for all the antigens tested in a protein-specific and time-dependent manner. Women who recovered from COVID-19 at trimester I–II showed a noticeable decrease in the number of milk samples with sIgA specific to the N-protein, linear NTD, and RBD-SD1 epitopes, and showed an increase in samples with RBD conformation-dependent sIgA. S-antigens were found to solely induce a sIgA1 response, whereas N-protein sIgA1 and sIgA2 subclasses were involved in 100% and 33% of cases. Overall, the antibody immunological landscape of convalescent donor milk suggests that it may be a potential defense agent against COVID-19 for infants, conferring them with a passive immunity