Immuno-hormonal and dopplerometric characteristics of placental insufficiency in pregnant women with exacerbation of chronic bronchitis associated with reactivation of cytomegalovirus infection

Aim. To give immune-hormonal and dopplerometric characteristics of placental insufficiency in pregnant women with exacerbation of chronic bronchitis associated with reactivation of cytomegalovirus infection (CMVI).

Ma­terials and methods. The concentration of IL-ie, IL-2 and progesterone was studied in the blood serum, and the pulsation index (PI) in the right uterine artery (RUA) was determined in 80 patients at 21-24 weeks of gestation, uncomplicated and complicated by exacerbation of chronic simple bronchitis due to reactivation of CMVI. In a retrospective analysis, 3 groups were formed. The first group - 30 women with CMV-seronegative physiological pregnancy; the second - 25 patients with chronic bronchitis in the acute stage, initiated by the acute phase of CMVI, leading to chronic compensated placental in­sufficiency (CCPI); the third - 25 women with exacerbation of chronic bronchitis CMVI etiology, causing the development of chronic subcompensated placental insufficiency (CSPI) in the third trimester of gestation.

Results. In the first group, the concentration of IL-ie was 22.8±0.02 pg/mL, IL-2 - 30.6±2.34 pg/mL, progesterone - 130.8±8.19 nmol/L, and the value of PI in RUA - 0.83±0.04 rel. units. In patients of the second group, compared with the first, the level of IL-ie in­creased by 3.82 times (p<0.00i), IL-2 - by 2.55 times (p<0.00i) and PI in the RUA - by i.40 times (p<0.00i) against the background of a decrease in the progesterone concentration by i.47 times (p<0.00i). The third group compared with the first was characterized by an increase in the concentration of IL-ie by 6.87 times (p<0.001), IL-2 - by 3.19 times (p<0.001) and PI in RUA by i.66 times (p<0.00i) with lower levels of progesterone (i.93 times, p<0.00i). In the third group, in contrast to the second one, an increase in IL-ie was observed by 1.79 times (p<0.001), IL-2 - by 1.24 times (p<0.05) and PI in RUA - by i.i7 times (p<0.05), as well as a decrease in progesterone levels by i.3i times (p<0.0i). There was an in­crease in the relationship of PI in RUA with the concentration of IL-ie (r=0.69; p<0.001), IL-2 (r=0.75; p<0.001) and progesterone (r=-0.55; p<0.01).

Conclusion. A more pronounced systemic inflammatory reaction, leading to inhibition of progesterone synthesis and increased resistance to blood flow at RUA develops in exacerbation of chronic bronchitis in the second trimester of gestation against the background of reactivation of CMVI, which initiates the development of CCPI, in comparison with the exacerbation of bronchopulmonary pathology of a similar etiology, which determines the formation of subsequent CCPI.

1. Andrievskaya I.A., Dovzhikova I.V., Ishutina N.A., Gorikov I.N., Dorofienko N.N., Petrova K.K., Prikhodko N.G. Soluble tumor necrosis factor receptor 1 is a potential marker of inflammation in the trophoblast associated with cytomegalovirus infection. Am. J. Respir. Crit. Care Med. 2019; 99:А6173. https://doi.org/10.1164/ajrccm-conference.2019.199.1_MeetingAbstracts.A6173

2. Gorikov I.N., Andrievskaya I.A. Ishutina N.A., Dovzhikova I.V., Petrova K.K., Prikhodko N.G., Pavlenko V.I., Kolosov V.P. Estrogen deficiency and its manifestations in pregnant women with exacerbation of chronic simple bronchitis of cytomegalovirus etiology. Eur. Respir. J. 2021; 58(65 Suppl):A1891. https://doi.org/10.1183/13993003.congress-2021.PA1891

3. Ryazantseva N.V., Novitskii V.V., Belokon V.V., Zima A.P., Zhukova O.B., Naslednikova I.O., Litvinova L.S., Ko- lobovnikova Yu.V., Chasovskih N.U. [Cytokines and antiviral immunity]. Uspekhi fiziologicheskikh nauk 2006; 37(4): 33-44 (in Russian).

4. Lomova N.A., Ordzhonikidze N.V., Vanko L.V. [Systemic inflammatory response syndrome and pregnancy (a review of literature)]. Obstetrics and Gynegology 2012; (1):23-27 (in Russian).

5. Dolgushina V.F., Dolgushin I.I., Kurnosenko I.V., Lebedeva Yu.V. [Clinical and immunological criteria of intrauterine infection]. Akusherstvo i Ginekologiya/Obstetrics and Gynecology 2017; (1):40-45 (in Russian). http://dx.doi.org/10.18565/aig.2017.1.40-5.

6. Prokhorenko T.S., Saprina T.V., Ryazantseva N.V., Novitsky V.V., Vorozhtsova I.N., Martinova S.Yu., Reztsova V.M., Vasilyeva O.A., Latypova V.N. [Role of IL-2 and IL-4, and their recertors in immune mechanisms of autoimmune thyroiditis]. Siberian Medical Journal (Tomsk) 2011; 26(4-2):186-189 (in Russian).

7. Chen H., Malentacchi F., Fambrini M., Harrath A.H., Huang H., Petraglia F. Epigenetics of estrogen and progesterone receptors in endometriosis. Peprod. Sci. 2020; 27(11):1967-1974. https://doi.org/10.1007/s43032-020-00226-2

8. Repina М.А. [Progesterone and pregnancy]. Journal of Obstetrics and Womans Diseases 2011; 60(30:130-135 (in Russian).

9. Strizhakov A.N., Voloshchuk I.N., Timokhina E.V., Kozlova U.A. [Morphofunctional changes in the placenta with placental insufficiency of varying severity]. Voprosy ginekologii, akusherstva i perinatologii 2010; 9(2):5-11 (in Russian).

10. Milovanov A.P. [Pathology of the mother-placenta-fetus system]. Moscow: Meditsina; 1999 (in Russian). ISBN: 978-5-225-02775-9

11. Markina N.V., Stepanova O.A., Shamaeva T.N., Bolotov A.A. [Biomedical Data Statistical Tutorial]. Chelyabinsk: YuUGMU; 2014 (in Russian). Available at: https://www.books-up.ru/ru/book/uchebnoe-posobie-po-statisticheskoj-obra-botke-mediko-biologicheskih-dannyh-11852324

12. Voevodin D.A., Rozanova G.N. [Cytokines-hormones interrelation - concept of immune-endocrine regulatory system]. Pediatrics (Journal named after G.N.Speransky) 2006; 85(1):95-102 (in Russian).

13. Haitov R.M. [Immunology: textbook]. Moscow: GEOTAR-Media; 2016 (in Russian). ISBN: 978-5-9704-4655-3.

14. Provotorov V.M., Budnevsky A.V., Semenkova G.G., Shishkina E.S. [Proinflammatory cytokines in combination of coronary heart disease and chronic obstructive pulmonary disease]. Klin. Med. (Mosk) 2015; 93(2):5-9 (in Russian). PMID: 26117912.