Until now, the main reasons leading to pronounced shifts in the immune system have not been fully
studied. At the same time, the study of the state of the immune system during pathological pregnancy can
contribute to the pathogenetic substantiation of rational ways of the ante-and intra-natal protection of the
fetus and the prevention of complications during childbirth. The aim of study was to investigate the content of
pro inflammatory and anti-inflammatory cytokines in pregnant women at risk of developing PB.
MATERIALS AND METHODS
There were 42 women examined in the third trimester of gestation with the risk of premature birth: recurrent
with burdened obstetric history (abortion, preterm birth), with dysbiosis of the vagina and intestines. The study
did not include patients with isthmic cervical insufficiency, uterine malformations and myomas, as well as
carriers of TORCH infection. All patients came to the clinic with complaints of lower abdominal pain,
constipation, poor health, dysuric disorders, and the presence of abnormal discharge from the genital tract.
In 86% of women in the vaginal contents using polymerase chain reaction diagnostics revealed the
presence of pathogenic microflora and mixed infections. The species composition of the microbiocenosis of the
vagina and the cervical canal of female patients was characterized by the predominance of the share of
coccobacillary flora and gardnerellas. The diagnosis of bacterial vaginosis was established on the basis of
clinical and anamnestic indicators, and verified according to light microscopy of a smear from the posterior
vaginal fornix and determining the reaction of vaginal secretions (pH-metry). To describe the microscopic
picture of the vaginal biocenosis, light microscopy of smears stained by Gram was performed (Lyumam-P8
microscope, JIOMO, St. Petersburg). The degree of vaginal dysbiosis was determined microscopically by the
criteria proposed by Mavzyutov et al. [7]. Later bacteriological cultures were carried out with a quantitative
analysis of the microbiocenosis.
Determination of the cytokine status of IL-1β, IL-4, IL-6, IL-8, IL-10 and TNF-α in the serum of peripheral
blood was performed by Enzyme immunoassay. The data obtained in 24 women with physiological pregnancy
were used as controls.
Statistical analysis
Statistical data processing included determining the arithmetic mean and arithmetic mean error.
Reliability of differences was calculated by Student's t-test.
RESULTS
It was established that by women of the control group the level of cytokine IL-1β in serum was 2.35±0.18 pg/ml,
IL-4: 5.76±0.44 pg/ml. The serum content of IL-6 was 2.25±0.17 pg/ml, IL-8: 6.36±0.58 pg/ml, IL-10: 23.14±1.57
pg/ml, and TNF-α level was in the range of 1.68±0.13 pg/ml (Table 1).
Analysis of indicators of pregnant women of the main group revealed a significant increase in serum IL-1β
production by 6.7 times (14.6±0.87 pg/ml, P<0.05). IL-1 is an inducible protein, the synthesis of which is
necessary for the acute phase response. The main producers of cells are monocytes, macrophages, endothelium
and other cells. An excessively high level of IL-1 indicates the possibility of undesirable immunopathological
processes. IL-1 is characterized by the ability to stimulate prostaglandin production. Keeping this cytokine low
is one of the factors contributing to pregnancy.
By pregnant women with the risk of premature birth, the level of IL-8 was increased 1.6 times (9.98±0.63
pg/ml) compared with the same indicator in the control group. A high level of spontaneous production of IL-8
may indicate a significant activation of mononuclear phagocyte-producing pro-inflammatory cytokines, which
play an important role in the development of immunopathological processes [8].
The obtained data on the increase in IL-1β and IL-8 are a reflection of the activity of the inflammatory
process. An increase in the concentration of pro-inflammatory cytokines suggests that the inflammatory
response in a given cohort of pregnant women has systemic manifestations. At the same time, IL-1 stimulates
the release of stab leukocytes from the bone marrow, increases the formation and release of collagenase, causes
the expression of endothelial-leukocyte adhesive molecules on the surface of endothelial cells and leukocytes,
contributes to marginal standing of leukocytes and stimulates the process of their emigration.
As its shown by the results of our studies, pregnant women at risk of premature birth have an increase in
serum IL-6 content 2.1 times (4.83±0.39 pg/ml) compared with the data of healthy pregnant women (P<0.05).
Citation: Khakimovna RN. Results of cytokine research of pregnant women with the risk of premature birth.
J Life Sci Biomed, 2019; 9(5): 126-129;
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