RU2541176C1 - Method for assessing threatening embryo death in aggravated cytomegalovirus infection at early stages of gestation, leading to lower cortisol concentration in peripheral blood - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: cytomegalovirus IgG antibody titre and cortisol level are measured in pregnant woman's peripheral blood at the moment of aggravation. Substance of the method: a cytomegalovirus IgG antibody titre and a cortisol level are measured in pregnant woman's peripheral blood at the moment of aggravation of the cytomegalovirus infection. If the cytomegalovirus IgG titre is 1:1600, and the cortisol level is 563.0±19.2 nmole/l with the reference of 1,399.4±25.5 nmole/l, threatening miscarriage or missed miscarriage is stated.

EFFECT: stating threatening embryo death accompanying the cytomegalovirus infection at the early stages of gestation depending on the cortisol level in peripheral blood.

Description

The invention relates to medicine, namely to the problem of creating new methods for diagnosing the threat of death of an embryo during especially dangerous viral infections during pregnancy, such as cytomegalovirus.

As you know, cortisol is formed mainly in the bundle zone of the adrenal cortex [8, 9]. The steroid is synthesized from cholesterol in the following way: cholesterol → pregnenolone → 17-hydroxyprogesterone → 11-deoxycortisol → cortisol (hydrocortisol). Moreover, adrenocorticotropic hormone is the main regulator of cortisol biosynthesis [9].

Cortisol affects many metabolic processes by regulating enzymatic activity, and also stimulates the biosynthesis of liver protein, accelerates transaminase reactions in many organs, stimulates gluconeogenesis reactions, and increases the glycogen content in the liver and glucose in the blood [4, 7, 12]. Most cortisol is associated with albumin and transcortin [3, 6, 11, 13, 15].

Cortisol is sensitive to external factors caused by infectious pathogens [10, 13, 14]. Corticosteroids have a pronounced destructive effect, causing involution of the lymph nodes and thymus. The regulatory effect of cortisol in most diseases of the internal organs has been shown: cardiovascular diseases, pathology of the musculoskeletal system, diseases of the gastrointestinal tract [3, 5, 6, 10, 13, 14]. During pregnancy, there is a change in cortisol metabolism, especially with exacerbation of diseases of various organs [1, 2, 6]. Under stressful processes and when the organism is exposed to infectious factors, a change in the metabolism of cortisol is noted — a violation of the connection with transcortin due to a decrease in its synthesis [11, 14, 15, 16].

In this regard, knowledge of the formation of the response of the pregnant woman to changes in cortisol metabolism during exacerbation of cytomegalovirus infection, especially in the first weeks of gestation, is of great importance. This is due to the fact that cytomegalovirus can directly change the nature of metabolic and metabolic processes (protein synthesis, carbohydrates), controlled and regulated by cortisol, which creates a threat of abortion.

However, the problem of determining the threat of miscarriage in pregnant women with exacerbation of cytomegalovirus infection remains unresolved to date.

The aim of the present invention was to develop a method for assessing the threat of death of the embryo during exacerbation of cytomegalovirus infection in the early stages of gestation, depending on the content of cortisol in the peripheral blood.

Achievable technical result is to determine the threat of death of the embryo during exacerbation of cytomegalovirus infection in the early stages of gestation, depending on the content of cortisol in the peripheral blood.

The claimed method has the following techniques:

1. The studies were carried out on the basis of the obstetric department of the Federal State Budgetary Institution "Far Eastern Scientific Center of Physiology and Pathology of Respiration" SB RAMS. 25 pregnant women with gestational age of 5-12 weeks at the age of 18-25 years with chronic cytomegalovirus infection in the acute stage were examined. In pregnant women, symptomatic cytomegalovirus infection manifested itself as an acute respiratory disease, accompanied by rhinopharyngitis. The clinical diagnosis - exacerbation of cytomegalovirus infection - was established during a comprehensive study of peripheral blood for the presence of IgM or a fourfold or more increase in the titer of IgG antibodies in paired sera over time after 10 days, avidity index more than 65%, as well as cytomegalovirus DNA. The studies were carried out taking into account the requirements of the Helsinki Declaration of the World Medical Association “Ethical Principles for Conducting Scientific Research Based on Man” as amended in 2000 and the rules of clinical practice in the Russian Federation, approved by order of the Ministry of the Russian Federation No. 266 of 06/19/2003

2. Verification of cytomegalovirus, determination of type-specific antibodies IgM and IgG, avidity index was carried out by enzyme-linked immunosorbent assay on a microplate reader “Stat Fax - 2100” using test systems of CJSC “Vector-Best” (Novosibirsk), detection of cytomegalovirus DNA by PCR using DT -96 using sets of NPO DNA Technology (Moscow).

3. The content of cortisol in peripheral blood was determined using test systems of Alkor Bio CJSC (St. Petersburg) on a Stat Fax - 2100 microplate reader (USA).

Studies have shown that with exacerbation of cytomegalovirus infection in the early stages of gestation (5-12 weeks), which was characterized by the presence of IgM to cytomegalovirus in the peripheral blood, an IgG antibody titer of 1: 1600, an avidity index of 87%, and a cytomegalovirus DNA virus replication marker in the cervical canal scraping , in pregnant women, a dynamic decrease in the content of cortisol in the peripheral blood was determined. Initially, at the time of exacerbation of the disease with a period of 5-6 weeks of gestation, the content of cortisol in the peripheral blood of such pregnant women was 1399.4 ± 25.5 nmol / L. By 8–9 weeks of gestation, the level of cortisol in these pregnant women decreased to 920.0 ± 14.2 nmol / L, and by 10–11 weeks it was 563.0 ± 19.2 nmol / L. In 15 cases, the pregnancy ended in a spontaneous miscarriage for a period of 10-11 weeks and 10 cases - a missed pregnancy for a period of 8-9 weeks.

Thus, exacerbation of cytomegalovirus infection leads to metabolic disorders in both the pregnant woman and the villous chorion, which is due to a decrease in the synthesis of cortisol in the adrenal glands, and with hormone levels of 563.0 ± 19.2 nmol / L, the embryo dies and spontaneously miscarriage.

Literature

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Claims (1)

A method for assessing the threat of embryo death during exacerbation of a cytomegalovirus infection in the early stages of gestation and a decrease in the cortisol content in the pregnant woman’s peripheral blood, comprising measuring the pregnant woman’s IgG anti-cytomegalovirus antibody titer and cortisol level and at an IgG titer of 1: 1600 and level cortisol 563.0 ± 19.2 nmol / l with the initial 1399.4 ± 25.5 nmol / l determine the presence of a threat of spontaneous miscarriage or missed pregnancy.