New prognostic criterion for the outcome of pregnancy in patients with threatening preterm birth.

To identify new criteria for predicting the outcome of pregnancy in women with threatened preterm labor based on the establishment of the characteristics of differentiation and functional activity of memory T-cells in the population of CD8 + T-lymphocytes. The study involved 56 women with threatened preterm labor at 22-34 weeks of pregnancy. Depending on the outcome of pregnancy, patients were divided into 3 groups: Group I included 22 women by premature labor; group II - 34 women whose pregnancy ended by deliver at term. By tricolor flow cytofluorometry method the content of peripheral Tn, Tcm, Tem and Temra cells in CD8+ population was studied. Statistical analysis was carried out using programs «Statistica for Windows 13.0¼, «Microsoft Excel 2019¼ and «MedCalc 19.3¼. Patients with the threat of preterm birth were characterized by a significant increase in the relative content of CD8+ T-lymphocytes in the peripheral blood compared to the control group (p=0.001). When comparing this indicator in the subgroups of women with the threat of preterm birth, it was found that preterm birth was associated with significantly higher relative CD8 + lymphocyte counts (p=0.03) compared to the indicators of the subgroup of women who gave birth on time. When evaluating the results obtained, it was found that the percentage of CD8+Temra GranzymeB-producing cells in the group of patients with threatened preterm birth, whose pregnancy ended in preterm birth, was significantly lower than in the group of women who gave birth on time (p=0.003). The content of Tcm, Tem memory cells producing GranzymeB in the subgroups of women with pregnancy outcomes of timely and preterm birth did not have significant differences compared to the control group. Thus, the prediction of preterm birth is possible with a value of GranzymeB-producing CD8 + Tem equal to 8.2% or less (sensitivity-87.9%, specificity-85%, accuracy-87.9%). Thus, the identification of a new criterion will make it possible to predict preterm birth in a timely manner and promote the choice of optimal pregnancy management tactics, reasonable prevention of fetal respiratory distress syndrome and transfer of a woman to an obstetric hospital designed to provide high-tech care to premature newborns.

[Method for predicting perinatal hypoxic lesions of the central nervous system in newborns.]

Perinatal lesions of the Central nervous system (CNS) in newborns occupy a leading place in the structure of perinatal morbidity and subsequent disability of children. To identify the features of the content of sRAGE in pregnant women with threatening preterm labor (UPR) in the period of 22-27 weeks, who subsequently gave birth to children with perinatal CNS lesion. Serum of venous blood of pregnant women with UPR at the term of 22-27 weeks was determined by ELISA once the content of sRAGE. If the value of sRAGE in pregnant women is 659.5 PG/ml or less, perinatal hypoxic lesions of the Central nervous system in newborns are predicted with an accuracy of 75.8% (sensitivity of 82.6%, specificity of 66.7%).

[Relationship between activation of endometrial CD56+ natural killers and the character of leiomyoma nodules growth in patients with uterine leiomyoma.]

In patients with different clinical variants of uterine leiomyoma (large or small size, presence or absence of intensive proliferation of tumor cells) the comparative analysis of endometrial CD56+ natural killers (NK) activation was carried out. The relative content of CD56+ cells, expressing of CD158a and CD158i molecules from KIR (killer immunoglobuline-like receptors) family, interferon γ (IFNγ) and transforming growth factor ß1 (TGFß1), was estimated by flow cytometry method. It was found that in the endometrium of all patients with uterine leiomyoma independently of tumor size the content of CD56+ cells and the amount of NK, expressing both activating (CD158i) and inhibitory (CD158a) receptors, were increased. In group of women with stably small uterine leiomyoma the amount of CD56+IFNγ+ lymphocytes was increased, and in women with rapidly growing tumor the elevation of NK, expressing TGFß1, was noted. Differential analysis of data in patients with large leiomyoma in dependence of type of leiomyoma growth was shown that in patients with the high level of tumor cells proliferation the amount of CD56+ NK and the ratio of NK with activating and inhibitory receptors were lower and the content of CD56+TGFß1+ lymphocytes was higher than that in women with leiomyoma, which grew due to accumulation of the extracellular matrix components. Received results showed on the suppression of cytotoxic activity of endometrial NK in patients with uterine leiomyoma with increased proliferation. These changes can be used as additional diagnostic criteria of type of leiomyoma growth.

Cytokine production by immunocompetent cells of peritoneal fluid in women with external genital endometriosis.

The content of some cytokines in the peritoneal fluid and the level of their in vitro production by peritoneal macrophages and lymphocytes were evaluated in women with external endometriosis. The ratio of peritoneal lymphocytes and macrophages in the peritoneal fluid was changed in endometriosis because of increased percentage of lymphoid cells and decreased content of macrophages, in the presence of high absolute counts of both types of cells. The cytokine status of women with endometriosis was characterized by higher levels of IL-1beta, TNF-alpha, and epidermal growth factors both in the peritoneal fluid and supernatants of 24-h cultures of peritoneal macrophages; the content of IFN-alpha remained unchanged. The concentrations of IFN-gamma in the peritoneal fluid did not change in endometriosis, but increased in the supernatants of peritoneal lymphocyte cultures.