FREE-RADICAL OXIDATION AND OXYGENATION OF HEMOGLOBIN AT EXACERBATION OF CYTOMEGALOVIRUS INFECTION IN THE SECOND TRIMESTER OF PREGNANCY

The aim of the study was to assess free radical processes and their effect on oxygenation of hemoglobin in the blood of 18-21 weeks  pregnant women with exacerbation of cytomegalovirus infection. We  examined 40 pregnant women with exacerbation of cytomegalovirus  infection and various levels of specific antibodies (IgM) at 18-21  weeks and 30 pregnant women without cytomegalovirus. The  spectrophotometric method was used to determine the content of oxyhemoglobin, methemoglobin, thiobarbituric acid (TBA)-active  products, superoxide dismutase in blood erythrocytes; thin layer  chromatography – phosphotidylcholine, lysophosphatidylcholine;  gas-liquid chromatography – arachidonic acid. Exacerbation of  cytomegalovirus infection changes the activity of free radical  oxidation processes, the severity of which is determined by the level  of IgM antibodies and is manifested by a decrease in superoxide  dismutase (p = 0.000) and phosphatidylcholine (p = 0.000), an  increase in phospholipase A2 (p = 0.000), lysophosphatidylcholine (p  = 0.000), arachidonic acid (p = 0.000) and TBA-active products  (p = 0.000). Accumulation of superoxide anion radical and products of lipoperoxidation in erythrocytes decreases  oxyhemoglobin (p = 0.000) and increases methemoglobin (p =  0.000). Exacerbation of cytomegalovirus infection at 18-21 weeks is  associated with the enhancement of free radical lipid oxidation and a  deficiency in the antioxidant activity of superoxide dismutase. It  decreases oxygen transport properties and increases phagocytosis  by red blood monocytes; and pregnant women develop further  hemic hypoxia

INFLUENCE OF LIPID PEROXIDATION PROCESSES ON OXYGEN-TRANSPORT PROPERTIES OF HEMOGLOBIN IN ERYTHROCYTES OF PERIPHERAL BLOOD OF PREGNANT WOMEN WITH CYTOMEGALOVIRUS INFECTION

The article is devoted to the study of activity of lipid peroxidation processes and their influence on oxygen-transport properties of hemoglobin in erythrocytes of peripheral blood of pregnant women with cytomegalovirus infection. Activation of lipid peroxidation processes in pregnant women with cytomegalovirus infection determined by the contents of TBA-active products is accompanied by accumulation of cytotoxic factors - arachidonic acid (1 trimester - up by 31 %, 11 trimester - up by 68 %, 111 trimester - up by 41 %) and lysophosphatidylcholine (1 trimester - up by 85 %, 11 trimester - up by 55 %, 111 trimester - up by 13 %), causes disorders of oxygen-transport properties of hemoglobin in erythrocytes (decrease of total erythrocytes and hemoglobin count), more than double increase of indices of thermolabile hemoglobin at slight decrease of oxyhemoglobin, increase of methemoglobin (1 trimester - up by 60 %, 11 trimester - up by 25 %, 111 trimester - up by 16 %, in comparison with control), that causes decrease of transportation and delivery of oxygen to the tissues and can be the reason of hypoxia

The Role of Cytokines in the Development of Early Pregnancy Loss in Women with a History of Metabolic Disorders

Background. Spontaneous miscarriage is the most common complication of pregnancy. Obesity increases the risk of adverse pregnancy outcomes. Aim of the study. To assess the cytokine profile as a marker of spontaneous miscarriage in women with metabolic disorders in the past medical history. Materials and methods. A prospective study of 170 adolescent girls with metabolic disorders was conducted between 2000 and 2013. Assessment of menstrual and reproductive function was carried out in 86, pregnancy outcomes – in 72 women. The average age of women in reproductive age was 21.95 ± 0.2 years, BMI – 24.7 ± 3.9 kg/m2. Results. In women with early pregnancy losses and metabolic disorders in past medical history, the predictor of an early pregnancy loss is an increase in the ratio of pro- and anti-inflammatory cytokines TNF-a/IL-10 in serum at 7–8 weeks of gestation (OR = 2.29). It was determined a significant correlation between the levels of pro- and anti-inflammatory cytokines of the same name in serum and chorion (IL-10 (p = 0.000) and TNF-α/IL-10 (p = 0.001), which indicates similar changes in chorion. The activity of NF-kB in chorion was 5.75 ± 0.51 pg/ml. Conclusions. The findings suggest that the cytokine balance of pro- and anti-inflammatory cytokines in women with metabolic disorders in past medical history is an important component in the development of early pregnancy losses

Особенности вазоактивной регуляции в ворсинчатом хорионе у женщин с самопроизвольным абортом и активной цитомегаловирусной инфекцией

The aim of the study was to assess the levels of soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF), and vascular endothelial growth factor A (VEGF-A) in tissue extracts in comparison with the histologic examination of the endometrium and chorionic villi in women with spontaneous abortion and active cytomegalovirus (CMV) infection.Materials and methods. 81 women at 7–9 weeks of pregnancy were examined: of them, 51 women were CMVseropositive with active infection and after spontaneous abortion, and 30 patients were CMV-seronegative, healthy women after therapeutic abortion. Immunoglobulins (Ig) M and G to CMV and CMV IgG avidity were measured in the blood plasma; sFlt1, PlGF, and VEGF-A were determined in extracts of chorionic villi by enzyme immunoassay. CMV DNA was detected in mononuclear cells of peripheral blood, urine, and chorionic villi by real-time polymerase chain reaction (PCR). A histologic examination of the endometrium and chorionic villi was carried out.Results. In chorionic villus extracts of women with spontaneous abortion and active CMV infection, the concentration of sFlt1 was 3.25 times higher (p < 0.001), and the levels of PlGF and VEGF-A were 1.31 (p < 0.001) and 2.16 times lower (p < 0.001) than in healthy women. A strong negative correlation was established between the levels of sFlt1 and PlGF (r = –0.702; p < 0.001) and VEGF-A (r = –0.858; p < 0.0005), and a positive correlation was revealed between PlGF and VEGF-A levels (r = 0.860; p < 0.001). According to the data of the histologic examination, a lag in decidual transformation of uterine vessels, trophoblast invasion, growth and differentiation of villi, and formation of fetal circulation was detected.Conclusion. The mechanisms of spontaneous abortion in women with active CMV infection include an imbalance of pro- and anti-angiogenic factors, which causes impaired placental development and uteroplacental circulation.Цель. Оценить содержание растворимого рецептора fms-подобной тирозинкиназы (sFlt1), плацентарного фактора роста (PlGF) и васкулоэндотелиального фактора роста (VEGF-А) в тканевых экстрактах в сопоставлении с гистологией слизистой оболочки матки и ворсинчатого хориона у женщин с самопроизвольным абортом и активной цитомегаловирусной (ЦМВ) инфекцией.Материалы и методы. Обследована 81 женщина в период с 7-й по 9-ю нед беременности: 51 ЦМВ-серопозитивная с самопроизвольным абортом и активной инфекцией и 30 серонегативных здоровых женщин с медицинским абортом. В плазме крови определяли иммуноглобулины (Ig) класса М и G к ЦМВ, авидность ЦМВ-IgG; в экстрактах ворсинчатого хориона – sFlt1, PlGF, VEGF-А методом иммуноферментного анализа. В мононуклеарных клетках крови, пробах мочи, ворсинчатом хорионе методом полимеразной цепной реакции в режиме реального времени выявляли ДНК ЦМВ. Проводили гистологическое исследование слизистой оболочки матки и ворсинчатого хориона.Результаты. В экстрактах ворсинчатого хориона у женщин с самопроизвольным абортом и активной ЦМВ-инфекцией концентрация sFlt-1 была выше в 3,25 раза (р < 0,001), PlGF и VEGF-А – ниже в 1,31 (р < 0,001) и 2,16 раза (р < 0,001), чем у здоровых женщин. Установлена сильная обратная корреляционная связь между уровнями sFlt-1 и PlGF (r = –0,702; р < 0,001) и VEGF-А (r = –0,858; р < 0,0005), прямая связь – PlGF и VEGF-А (r = 0,860; р < 0,001). По данным гистологического исследования, отмечено отставание в децидуализации и трансформации маточных сосудов, инвазии трофобласта, роста и дифференцировки ворсин, формирования фетальных сосудов.Заключение. К механизмам самопроизвольного аборта у женщин с активной ЦМВ-инфекцией можно отнести дисбаланс анти- и проангиогенной регуляции, вызывающий ограничение развития плаценты и маточно-плацентарного кровообращения.