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Контактная информация Николай Геннадьевич Приходько, аспирант, лаборатория механизмов этиопатогенеза и восстановительных процессов дыхательной системы при неспецифических заболеваниях легких, Федеральное государственное бюджетное научное учреждение «Дальневосточный научный центр физиологии и патологии дыхания, 675000, Россия, г. Благовещенск, ул. Калинина, 22.

Aim. To carry out a comparative analysis of the phospholipid profiles and annexin V content in the villous chorion obtained from women with spontaneous abortion associated with exacerbation of cytomegalovirus infection (CMVI) and the physiological course of pregnancy.Materials and methods. 66 patients were randomly selected at a gestational age of 6-8 weeks. A control group was identified in the amount of 32 healthy pregnant women with medical abortion. The main study group consisted of 34 women with spontaneous abortion associated with exacerbation of cytomegalovirus CMVI. The material for the study was the villous chorion, peripheral blood and urine. Type-specific antibodies to CMV immunoglobulins M and G class and the avidity index were determined in blood serum by the method of enzyme-linked immunosorbent assay. Lipids in the villous chorion homogenate were extracted with a chloroform-methanol mixture, phospholipids were fractionated by thin layer chromatography. The quantitative determination of annexin V was carried out by the method of enzyme immunoassay.Results. The phospholipid profile of the villous chorion in the main group was characterized by a decrease in the fraction of phosphatidylcholine to 22,39±0,04% (control group – 28,50±0,052%; p<0,001), phosphatidylethanolamine to 27,63±0,011% (control group – 30,11±0,073%; p<0,001), phosphatidylinositol up to 14,24±0,021% (control group – 16,17±0,018%; p<0,001), an increase in lysophosphatidylcholine up to 2,25±0,032% (control group – 1,07±0,022%; p<0,001), phosphatidylserine up to 14,57±0,075% (control group – 10,02±0,012%; p<0,001), sphingomyelin up to 18,92±0,012% (control group – 14,13±0,012%; p<0,001). At the same time, an increase in the content of annexin V was revealed up to 43,12±0,50 U/mL (control group – 20,21±0,50 U/mL; p<0,001).Conclusion. The results of the study showed that in the villous chorion from women with spontaneous abortion associated with exacerbation of CMVI, there was a change in the profile and ratio of phospholipids, as well as in the concentration of annexin V. The established increase in the content of phosphatidylserine and the associated annexin V in the villous chorion indicates a violation of the hemostatic system and microcirculation due to increased thrombus formation, which supports local inflammation and apoptosis of the trophoblast, which leads to embryonic demise and spontaneous abortion.

The aim of the study was to assess the levels of soluble fms-like tyrosine kinase 1 (sFlt1), placental growth factor (PlGF), and vascular endothelial growth factor A (VEGF-A) in tissue extracts in comparison with the histologic examination of the endometrium and chorionic villi in women with spontaneous abortion and active cytomegalovirus (CMV) infection.Materials and methods. 81 women at 7–9 weeks of pregnancy were examined: of them, 51 women were CMVseropositive with active infection and after spontaneous abortion, and 30 patients were CMV-seronegative, healthy women after therapeutic abortion. Immunoglobulins (Ig) M and G to CMV and CMV IgG avidity were measured in the blood plasma; sFlt1, PlGF, and VEGF-A were determined in extracts of chorionic villi by enzyme immunoassay. CMV DNA was detected in mononuclear cells of peripheral blood, urine, and chorionic villi by real-time polymerase chain reaction (PCR). A histologic examination of the endometrium and chorionic villi was carried out.Results. In chorionic villus extracts of women with spontaneous abortion and active CMV infection, the concentration of sFlt1 was 3.25 times higher (p < 0.001), and the levels of PlGF and VEGF-A were 1.31 (p < 0.001) and 2.16 times lower (p < 0.001) than in healthy women. A strong negative correlation was established between the levels of sFlt1 and PlGF (r = –0.702; p < 0.001) and VEGF-A (r = –0.858; p < 0.0005), and a positive correlation was revealed between PlGF and VEGF-A levels (r = 0.860; p < 0.001). According to the data of the histologic examination, a lag in decidual transformation of uterine vessels, trophoblast invasion, growth and differentiation of villi, and formation of fetal circulation was detected.Conclusion. The mechanisms of spontaneous abortion in women with active CMV infection include an imbalance of pro- and anti-angiogenic factors, which causes impaired placental development and uteroplacental circulation.

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