No abstract

To assess the markers of destabilization of homeostasis in women with ovarian hyperstimulation syndrome (OHSS), the investigation of the levels of cortisol, markers of renin-angiotensin-aldosterone system, endothelin, proinflammatory cytokines, acute phase proteins, and parameters of hemostasis was performed. Our survey involved 105 women who became pregnant after IVF: 21 women with symptoms of the early moderate and severe OHSS, 28 women with the late moderate and severe OHSS, and 56 pregnant women undergoing IVF without symptoms of OHSS. It was found significant increase of levels of cortisol, interleukins, the number of leucocytes, concentration of fibrinogen and D-dimers in patients with early and late OHSS. The development of late OHSS is associated with the lower level of IL-8 and ceruloplasmin. The OHSS is characterized by leukocytosis, higher level of IL-6, TNF-α, fibrinogen, D-dimers, thus reflecting the homeostasis imbalance. The determination of the level of fibrinogen, D-dimers, leukocytes can be an important screening test of the intensity of the inflammatory process in patients with OHSS.

We conducted a study of markers of endothelial dysfunction and angiogenesis regulation, as well as the identification of the main lymphocyte populations, activated CD3 + CD95+ -cells and cytokine-producing CD4 + IFN-g + -, CD4 + IL-4 + -lymphocytes in the 1st trimester of gestation in women with ART-induced pregnancy and spontaneous pregnancy. We used the same indicators to assess the immune status of ELBW infants at birth and at the post-conceptual age of 38-40 weeks. It was determined that the risk factors of very early preterm delivery are: threatened miscarriage, chronic placental insufficiency, endothelial dysfunction, increased spontaneous production of intracellular cytokines. Adverse perinatal outcomes in ELBW infants from ART-induced pregnancy are associated with lower anthropometric measures, low Apgar scores high level of inflammatory infections (pneumonia), grade II intraventricular hemorrhage, movement disorders in the form of lower paraparesis. Immune status of those infants is characterized by the increase in the number of CD8 + -and CD3 À CD16 + CD56 + -lymphocytes, the expression level of Fas-receptor by T-cells, and the increased production of intracellular and serum IFNg against the decrease in the number of CD4 + -cells, which indicates enhancing of cytotoxic effector potential and proinflammatory orientation of cell responses.

Резюме. Проанализированы результаты обследования 256 женщин в ранние сроки беременности, осложненной впоследствии плацентарной недостаточностью (106), прервавшейся в первом триместре (38) и протекавшей без признаков плацентарной недостаточности и закончившейся рождением живых доношенных детей (112). Оценивали содержание цитокинов и их растворимых рецепторов в сыворотке крови, спонтанную и индуцированную продукцию цитокинов клетками цельной крови, а также внутриклеточный синтез IFNγ и IL-4 Т-хелперами. Установлено, что ранние сроки беременности, протекавшей впоследствии с признаками компенсированной плацентарной недостаточности, ассоциируются с активацией митоген-индуцированной клеточной продукции IL-1β, а развитие субкомпенсированной ПН сопряжено с повышением уровня IL-1β и IL-1ra в сыворотке крови в тот же период гестации. Общим фактором риска развития субкомпенсированной плацентарной недостаточности и прерывания беременности в первом триместре является усиление митоген-индуцированного синтеза клетками крови IFNγ. Наряду с увеличением интерфероногенеза предиктором ранних репродуктивных потерь является клеточная гиперпродукция IL-2, а также повышение внутриклеточного синтеза Т-хелперами IFNγ и IL-4 в условиях дополнительной стимуляции, сопровождающееся усилением поляризации Th1/Th2.

We have studied HLA allogeneic interactions in short-term cultures of lymphocytes from the parents having children with congenital heart defects (CHD), or subject to early reproductive losses. Twentyone married couples (CHD as the main group) who had children with sporadic CHD (interventricular septal defect) without chromosomal diseases were observed. Fifty married couples (a comparison group) had two or more reproductive losses in early gestation (up to 9 weeks), denoted as PNPs (miscarriages, missed abortions, habitual miscarriages. Forty-one families with three or more healthy children represented a control group. Immune response in cell cultures was evaluated by increasing expression of HLA-DR in a mixed culture, as compared to spontaneous lymphocyte cultures. Initial labeling of female and male lymphocytes with monoclonal antibodies to CD45 conjugated to different fluorescent dyes (PC-5 and PC-7) allowed us to evaluate the immune response of female lymphocytes to males and vice versa. The suppressor effect of autologous female serum upon the mixed culture of the lymphocytes of the spouses was also evaluated. Results of the present study showed a difference in HLA allogeneic interactions in the short-term culture of lymphocytes registered for spouses with reproductive losses and children with congenital heart defects. Reproductive losses were associated with a low blocking effect of female auto-serum upon allogeneic HLA interactions in the short-term culture of the lymphocytes of the spouses. Congenital heart defects were associated with high activity of female B-lymphocytes (CD3-/HL-DR+) in short-term mixed culture of lymphocytes from the spouses.