Changes in the cytokine status in women with exacerbation of bronchial asthma due to reactivation of cytomegalovirus infection in the second trimester of pregnancy

Aim. To study changes in the cytokine status in women with exacerbation of bronchial asthma caused by reactivation of cytomegalovirus infection (CMVI) in the second trimester of gestation.

Materials and methods. The concentration of pro-inflammatory cytokines (TNFα, IL-1β, IFNγ, IL-2) in blood serum was assessed in 112 women in the second trimester of pregnancy, uncomplicated and complicated by exacerbation of asthma caused by reactivation of CMVI. The first group included 30 women seronegative for CMVI with uncomplicated pregnancy. The second group consisted of 30 patients with exacerbation of mild asthma associated with CMVI, initiating the formation of chronic compensated placental insufficiency. The third group consisted of 27 patients with exacerbation of moderate asthma induced by CMVI reactivation leading to the development of chronic compensated placental insufficiency. The fourth group included 25 women with exacerbation of moderate asthma due to the acute phase of CMVI, which induces the development of chronic subcompensated placental insufficiency.

Results. It was found that in the blood serum of women of the first group, the concentration of TNFα was (Me) 21.5 (13.8–30.1) pg/mL, IL-1β – 18.2 (13.6–34.0) pg/mL, IFNγ – 137.4 (109.5‒174.2) pg/mL and IL-2 – 29.8 (21.0‒38.9) pg/mL. In patients of the second group, compared with the first one, there was an increase in the level of TNFα by 3.79 times (p=0.000001), IL-1β – by 4.8 times (p=0.000001), IFNγ – by 1.73 times (p=0.000001) and IL-2 by 2.91 times (p=0.000001). In the third group, unlike the second one, no significant differences were found between the concentrations of TNFα, IL-1β, IFNγ, and IL-2. In patients of the fourth group, in comparison with the third group, higher values of TNFα (1.35 times, p=0.00507), IL-1β (1.86 times, p=0.000001), IFNγ (1.31 times, p=0.000167), and IL-2 (1.5 times, p=0.0056) were registered.

Conclusion. During exacerbation of moderate asthma of cytomegalovirus etiology, leading to chronic subcompensated placental insufficiency, in comparison with exacerbation of moderate asthma caused by reactivation of CMVI, initiating the formation of chronic compensated placental insufficiency, activation of the systemic inflammatory response is most pronounced, leading to stimulation of the migration of monocytes, lymphocytes and neutrophils to the focus of inflammation at the level of small bronchi; also leading to disruption of intersystem relationships and to hemodynamic dysfunction of the placenta.

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