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.

Character of ß-lymphocytes differentiation in women with hypertensive disorders during pregnancy.

The aim of the work was to identify the features of B-lymphocyte differentiation in women with hypertensive disorders of various origins, to establish their relationship with indicators of the elastic properties of the vascular wall, and to develop additional diagnostic criteria for the severity of preeclampsia. We examined 193 women at 24-40 weeks of gestation. Of these, 39 women with chronic arterial hypertension, 35 women with preeclampsia that developed against the background of chronic arterial hypertension, 55 with preeclampsia. The control group consisted of 64 women without hypertensive disorders. To assess the elastic properties of the vascular wall, a sphygmographic attachment of the "Poly-Spectrum-8" hardware-software complex ("Neurosoft" Ivanovo) was used. The relative content of B-lymphocytes (CD19 + and CD20 +), regulatory B-cells (CD20 + IL-10 +), switched (CD19 + CD27 + IgD-) and non-switched (CD19 + CD27 + IgD +) memory cells, plasma cells (CD19 + CD20-CD38 +) in the general population of B-lymphocytes was assessed by flow cytometry on a FACSCantoII flow cytometer using the FACS Diva program. Statistical analysis was carried out using the programs "Statistica for Windows 6.0", "Microsoft Excel 2010" and "MedCals". All subjects with hypertensive disorders showed an increase in the stiffness of the arteries of the muscular and elastic types, the most pronounced in the groups of patients with PE, the maximum in women with CAH and associated PE. An increased level of B1-lymphocytes in the peripheral blood is also noted in all hypertensive disorders. There were revealed positive correlations of high strength between: the level of CD20 + cells and the velocity of pulse wave propagation through the arteries of the muscular type (PWVm) in all groups with hypertensive disorders; the content of B1 cells and PWVM in moderate preeclampsia; level emory B-cells and PWV in elastic-type arteries in women with CAH and associated PE. The ROC analysis of the relative content of B1 cells in the general population of B lymphocytes and the content of IL-10-producing cells in the population of CD20 + lymphocytes (Breg) in women with moderate and severe PE revealed criteria for the differential diagnosis of preeclampsia of varying severity. The presence of hypertensive disorders of various origins is accompanied by a decrease in the elasticity of the arterial vascular wall, which is most pronounced in patients with CAH and associated PE. These changes are largely correlated with the level of B cells. As additional criteria for determining the severity of PE, the relative content of B1 cells and IL-10-producing cells in the population of Breg CD20 + lymphocytes can be used.

[The markers of inflammation reaction and dysfunction of endothelium in pregnant women with hypertension disorders of various genesis].

The markers of endothelium dysfunction and factors of inflammation in pregnant women with hypertension with hypertension disorders of various genesis were analyzed. The clinical laboratory study was carried out on the basis of sampling of 158 women at pregnancy period of22-3 7 weeks. Out of this sampling 30 women had previously present chronic arterial hypertension, 3 0 women had chronic arterial hypertension and consecutive preeclampsia, 43 women had preeclampsia and 55 women had uncomplicated course of pregnancy without hypertension disorders (control group). It is established that in pregnant women with hypertension disorders of various genesis endothelial dysfunction and inflammation are developed/ This occurrence is confirmed by increasing of in blood of number of circulating desquamated endotheliocytes, C-reactive protein and homocystein in all groups; by increasing of serum level of t-PA, endothelin (1-21), MMP-2, sVCAM-1 and IL-6 under preeclampsia, including one consecutive to chronic arterial hypertension; by increasing of content of IL-6 in blood serum under chronic arterial hypertension with consecutive preeclampsia. The criteria are developed concerning serum content of t-PA, sVCAM-1, endothelin (1-21) and MMP-2 permitting to diagnose differentially previously present hypertension and preeclampsia, including consecutive one to chronic arterial hypertension.