УО «Гродненский государственный медицинский университет», Гродно, Беларусь Введение. Децидуализация стромы эндометрия представляет собой многоэтапный процесс. Иммуногистохимическим маркером дифференцировки децидуальных клеток является десмин. Целью нашего исследования стала оценка особенностей децидуальной трансформации эндометрия, а также прогностической значимости уровня экспрессии десмина в децидуальных клетках при невынашивании беременности ранних сроков. Материал и методы. Проведен клинико-морфологический анализ 102 случаев невынашивания, выявленных у женщин Гродненской области в 2005 г. Иммуногистохимическое исследование выполнили с использованием мышиных моноклональных антител к рецепторам Desmin (М076001, Dako). Результаты. Уровень экспрессии десмина в строме эндометрия пациенток с невынашиванием беременности значимо выше, чем при нормальной беременности (р=0,002). Выводы. При уровне позитивности экспрессии десмина в строме эндометрия больше 0,004 можно с чувствительностью 100% и специфичностью 100% прогнозировать невынашивание беременности.

The article is devoted to the analysis of the morphological characteristics of placental tissue in women with early reproductive losses with recurrent miscarriage, depending on the presence of polymorphic variants of metalloproteinases and hemostasis. It was established that in women with recurrent miscarriage, the area of the trophoblast of the placenta is significantly larger (р < 0.003), the area of the chorionic villi is smaller (р < 0.04) than in the group of women with implemented reproductive function. Thrombosis of the chorionic vessels, necrosis and calcinates in the placenta with PNF were detected in 80.0 % (р = 0.001), 93.3 % (р = 0.001), and 30.0 % (р = 0.049) of cases, respectively, which is significantly higher than in the comparison group. In patients with PNP with the T/T genotype of the 735 C/T polymorphism of the MMP-2 gene, the trophoblast area is significant (р < 0.05) more than with the C/C genotype, acute full-back (р = 0.02) and intervillous hemorrhage (р = 0.02). In women with the C/T genotype of the polymorphism 735 C/T of the MMP-2 gene, edema and dystrophic changes in the chorionic villi, placental necrosis are determined more often (р = 0.02) than with the C/C genotype. In carriers of the T allele of the polymorphism 735 C/T of the MMP-2 gene in the placenta, necrosis is significantly more common than in the CC genotype; the carriage of the T allele is also associated with large values of the relative area of the trophoblast and the stromal-intervillous relation, as well as with a smaller value of the ratio of the intervillous space area to the total area of the photograph.

Aim. To investigate the specific features of the expression of second-type melatonin receptors (MTNR1B) by epithelial cells of the distal esophagus in gastroesophageal reflux disease (GERD), depending on the severity of endoscopic changes in the mucous membrane.Materials and methods. The study included 48 GERD patients, out of whom 37 and 11 people were suffering from non-erosive reflux disease (NERD) and erosive reflux disease (ERD), respectively. The control group consisted of 18 patients without GERD, comparable with the main groups by gender, age and body mass index. In order to determine the expression of MTNR1B, esophagogastroduodenoscopy with the collection of biopsy material from the mucous membrane of the distal esophagus was performed. The quantification of the MTNR1B expression intensity was carried out using the Aperio ImageScope_v9.1.19.1567 software. The level of melatonin metabolite, 6-sulphatehydroxymelatonin (6-SOMT), was determined in daily urine, as well as separately in daytime and nighttime portions.Results. The intensity of MTNR1B expression by esophageal epithelial cells in patients with NERD demonstrated no difference with the control group (0.436 (0.123, 0.668) and 0.437 (0.202, 0.692), respectively; p> 0.05). A significant decrease in the expression of MTNR1B receptors was noted in patients with ERD compared to NERD patients (0.127 (0.059, 0.156) and 0.436 (0.123, 0.668), respectively; p = 0.017) and patients in the control group (0.437 (0.202, 0.692); p = 0.033). The low intensity of MTNR1B expression was associated with more pronounced endoscopic changes in the mucous membrane of the esophagus (r = –0.40; p = 0.0015). A statistically significant relationship was found between the expression intensity of MTNR1B and the level of melatonin in the daytime (r = 0.42; p = 0.018), as well as the night/day index reflecting the daily rhythm of melatonin synthesis (r = –0.43; p = 0.016).Conclusions. The obtained data indicate that a decrease in the intensity of MTNR1B expression by esophageal epithelial cells can be considered as a prognostically unfavourable sign of the GERD course. The low intensity of MTNR1B expression is associated with a more severe (erosive) form of GERD and more pronounced endoscopic changes in the mucous membrane of the esophagus.