Іmmunological features in pregnant women with major obstetric syndromes
DOI:
https://doi.org/10.15574/HW.2024.171.45Keywords:
pregnancy, major obstetric syndromes, placental insufficiency, immunological indicators, cellular immunity, humoral immunityAbstract
Aim of the research – to evaluate the adaptive capabilities of the immunological system in pregnant women who had complications from the group of major obstetric syndromes (МОS) for the further development of an algorithm for the prevention of this complication.
Materials and methods. The main study group (MG) - 99 pregnant women who had a complication from the group of MOS, which was clinically manifested by placental insufficiency (PI); control group (CG) - 50 practically healthy pregnant women with a healthy reproductive history and an uncomplicated course of this pregnancy. The number (x109/l) and relative (%) of lymphocyte subpopulations CD3+ (T-lymphocytes), CD4+ (helper-inducers), CD8+ (cytotoxic suppressors), CD56+ (natural killers), CD19+ (B-lymphocytes) were determined; the presence of antiphospholipid antibodies (APA); total hemolytic activity of the classical way of complement activation (CH50); levels of IgG, IgM, IgA. Statistical processing of research results was carried out using standard Microsoft Excel 5.0 and Statistical 6.0 programs.
Results. In the I and II trimesters of pregnancy in MG and CG, a tendency to decrease was observed, СM4+ (51.8±2.5% and 48.9±1.6; 58.4±2.3% and 55.6±2.6%), and СD8+ (24.6±2.4% and 21.2±1.2%; 31.3±2.5% and 30.9±2.7%), which led to an increase in the immunoregulatory index (СD4+/СD8+) in MG (р<0.05). The level of СD19+, during gestation there was an increase in their relative number in MG (13.6±0.98%; 16.4±2.03% and 21.1±2.01%) (p<0.05); a predominance of the percentage of CD56+ lymphocytes, which have the properties of natural killers, was observed in pregnant MG (12.3±1.7%; 15.1±1.7%; 13.9±1.73% vs. 8.6±1.4%; 8.1±1.18%; 7.2±0.98%; p<0.05). Hemolytic activity of the classical pathway of complement activation (CH50) in MG pregnant women was 1.5 times higher compared to CG pregnant women (p<0.05). APA, represented by IgG to cardiolipin, were detected in 47 (47.5%) pregnant women MG and 4 (8.0%) women pregnant CG (p<0.05).
Conclusions. Іn pregnant women with МОS, there is an immune maladaptation that progressively increases in the dynamics of gestation and is manifested by excessive activation of natural killers (CD56+), an increase in the immunoregulatory coefficient (CD4+/CD8+), an increase in the percentage of B-lymphocytes (CD19+), dysimmunoglobulinemia, which is accompanied by high indicators of the general hemolytic activity of the classical pathway of complement activation (CH50), the presence of APA.
The research was conducted according to principles of Declaration of Helsinki. Protocol of research was proved by local ethical committee, mentioned in institution’s work. A informed sonsennt was collected in order to carry out the research.
The author is stating no conflict of interests is declared.
References
Abbas Y, Turco MY, Burton GJ, Moffett A. (2020). Investigation of human trophoblast invasion in vitro. Hum. Reprod. Update. 26: 501-513. https://doi.org/10.1093/humupd/dmaa017; PMid:32441309 PMCid:PMC7473396
Atrash H, Jack B. (2020). Preconception Care to Improve Pregnancy Outcomes: The Science J. Hum. Growth. Dev. 30(3): 355-362. https://doi.org/10.7322/jhgd.v30.11064
Bai K, Li X, Zhong J, Ng EHY, Yeung WSB, Lee CL, Chiu PCN. (2021). Placenta-derived exosomes as a modulator in maternal immune tolerance during pregnancy. Front. Immunol. 12: 671093. https://doi.org/10.3389/fimmu.2021.671093; PMid:34046039 PMCid:PMC8144714
Carter AM. (2021, Jul 28). Unique Aspects of Human Placentation. Int J Mol Sci. 22(15): 8099. https://doi.org/10.3390/ijms22158099; PMid:34360862 PMCid:PMC8347521
Carter AM. (2022, May 25). Evolution of Placental Hormones: Implications for Animal Models. Front Endocrinol (Lausanne). 13: 891927. https://doi.org/10.3389/fendo.2022.891927; PMid:35692413 PMCid:PMC9176407
Cha J, Sun X, Dey SK. (2012, Dec). Mechanisms of implantation: strategies for successful pregnancy. Nat Med. 18(12): 1754-1767. https://doi.org/10.1038/nm.3012; PMid:23223073 PMCid:PMC6322836
Cornish EF, McDonnell T, Williams DJ. (2022, Apr 22). Chronic Inflammatory Placental Disorders Associated With Recurrent Adverse Pregnancy Outcome. Front Immunol. 13: 825075. https://doi.org/10.3389/fimmu.2022.825075; PMid:35529853 PMCid:PMC9072631
Damhuis SE, Ganzevoort W, Gordijn SJ. (2021, Jun). Abnormal Fetal Growth: Small for Gestational Age, Fetal Growth Restriction, Large for Gestational Age: Definitions and Epidemiology. Obstet Gynecol Clin North Am. 48(2): 267-279. https://doi.org/10.1016/j.ogc.2021.02.002; PMid:33972065
Davenport BN, Wilson RL, Jones HN. (2022, Jul). Interventions for placental insufficiency and fetal growth restriction. Placenta. 125: 4-9. Epub 2022 Apr 4. https://doi.org/10.1016/j.placenta.2022.03.127; PMid:35414477 PMCid:PMC10947607
Docheva N, Romero R, Chaemsaithong P, Tarca AL, Bhatti G, Pacora P et al. (2019). The profiles of soluble adhesion molecules in the "great obstetrical syndromes". The Journal of Maternal-Fetal & Neonatal Medicine. 32(13): 2113-2136. https://doi.org/10.1080/14767058.2018.1427058; PMid:29320948 PMCid:PMC6070437
Gardella B, Dominoni M, Scatigno AL, Cesari S, Fiandrino G, Orcesi S, Spinillo A. (20220. What is known about neuroplacentology in fetal growth restriction and in preterm infants : A narrative review of literature. Front Endocrinol. 19; 13: 936171. https://doi.org/10.3389/fendo.2022.936171; PMid:36060976 PMCid:PMC9437342
Harper T, Kuohung W, Sayres L, Willis MD, Wise LA. (2023, Sep). Optimizing preconception care and interventions for improved population health. Fertil Steril. 120; 3 Pt 1: 438-448. Epub 2022 Dec 11. https://doi.org/10.1016/j.fertnstert.2022.12.014; PMid:36516911
Lager S, Sovio U, Eddershaw E, van der Linden MW, Yazar C, Cook E et al. (2020, Dec). Abnormal placental CD8+ T-cell infiltration is a feature of fetal growth restriction and pre-eclampsia. J Physiol. 598(23): 5555-5571. Epub 2020 Sep 16. https://doi.org/10.1113/JP279532; PMid:32886802
Mahajan S, Alexander A, Koenig Z, Saba N, Prasanphanich N, Hildeman DA et al. (2023, Sep 8). Antigen-specific decidual CD8+ T cells include distinct effector memory and tissue-resident memory cells. JCI Insight. 8(17): e171806. https://doi.org/10.1172/jci.insight.171806; PMid:37681414 PMCid:PMC10544202
Mancini G, Carbonara AO, Heremans JF. (19650. Immunochemical quantitation of antigens by single radial immunodiffusion. Immunochemistry. 2: 235-254. https://doi.org/10.1016/0019-2791(65)90004-2; PMid:4956917
Mintser AP. (2018). Statisticheskie metodyi issledovaniya v klinicheskoy meditsine. Prakticheskaya meditsina. 3: 41-45.
Piccinni MP, Robertson SA, Saito S. (2021. Oct 40. Editorial: Adaptive Immunity in Pregnancy. Front Immunol. 12: 770242. https://doi.org/10.3389/fimmu.2021.770242; PMid:34671364 PMCid:PMC8520997
Pereira RA, de Almeida VO, Vidori L, Colvero MO, Amantéa SL. (2023, Jan). Immunoglobulin G and subclasses placental transfer in fetuses and preterm newborns: a systematic review. J Perinatol. 43(1): 3-9. Epub 2022 Oct 8. https://doi.org/10.1038/s41372-022-01528-w; PMid:36209234
Schust DJ, Bonney EA, Sugimoto J, Ezashi T, Roberts RM et al. (2021, Feb 10). The Immunology of Syncytialized Trophoblast. Int J Mol Sci.;22(4):1767. https://doi.org/10.3390/ijms22041767; PMid:33578919 PMCid:PMC7916661
Tong M, Abrahams VM. (2020, Mar). Immunology of the Placenta. Obstet Gynecol Clin North Am. 47(1): 49-63. https://doi.org/10.1016/j.ogc.2019.10.006; PMid:32008671
Wang F, Jia W, Fan M, Shao X, Li Z, Liu Y et al. (2021, Apr). Single-cell Immune Landscape of Human Recurrent Miscarriage. Genomics Proteomics Bioinformatics. 19(2): 208-222. Epub 2021 Jan 19. https://doi.org/10.1016/j.gpb.2020.11.002; PMid:33482359 PMCid:PMC8602400
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