RU2624519C1 - Method for determination of human embryo implantation into uterine mucous membrane, depending on content of active receptors to estrogenes in chorion at cytomegalovirus infection exacerbation at first trimester of gestation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: titer of IgG antibody to CMV is determined on weeks 7-8 of gestation, and the content of active receptors for estrogen (ERα) in the chorion homogenate is determined, and when the titer of IgG antibodies to the cytomegalovirus is upto 1:1600, the ERα content in the chorion homogenate is reduced to 3.62±0.51 nmol/l, the threat of impaired embryo implantation into the uterine mucosa is determined, which can lead to its death in the form of spontaneous abortion.

EFFECT: increased accuracy of determination.

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Description

1. The purpose of the invention is to show the negative effect of exacerbation of cytomegalovirus infection in the first trimester of gestation on the implantation of a human embryo at 7-8 weeks of pregnancy due to a decrease in the content of estrogen receptor chorion cells (ERα).

2. The invention relates to medicine, namely to assess the effect of exacerbation of cytomegalovirus infection in the first trimester of gestation on the decrease in the content of estrogen receptors in the chorion, leading to disruption of the process of implantation of the embryo into the uterine mucosa.

3. Disclosure of invention

The number and functioning of receptors for steroid hormones - estrogens is an indicator of the well-being of embryo implantation in the uterine mucosa in the first weeks of pregnancy [1, 2]. Estrogen receptors are intracellular hormone receptors. For the successful implantation of the embryo into the uterine mucosa, it is necessary to coordinate the readiness for the process of uterine endometrium for this process. For implantation, endocrine regulation of hormones is required [3, 4]. Estrogens enhance the synthesis of their own progesterone and androgen receptors. Estrogen receptors affect the formation of placental villi and the formation of blood vessels in the uterine mucosa [5]. The insufficient content of estrogen receptors or their functional suppression leads to impaired embryo implantation and further development of the embryo, which creates the risk of spontaneous miscarriage.

4. New technical challenge

To develop a method for assessing the adverse effect of exacerbation of cytomegalovirus infection in the first trimester of gestation, which overwhelmingly affects the content of estrogen receptors in the chorion, creating a threat of spontaneous miscarriage.

5. In the available literature there is much information about the role of estrogen receptors in the early stages of gestation [1], but there is practically no literature covering the suppression of the activity of estrogen receptors in viral processes accompanying the first weeks of gestation. In the present study, the content of active estrogen receptors was carried out in the chorionic homogenate at 7-8 weeks of gestation with exacerbation of cytomegalovirus infection, which reduces the content of active estrogen receptors.

6. The implementation of the invention

6.1. We examined 20 pregnant women aged 18-26 years with chronic cytomegalovirus infection (HCMVI) in the acute stage at 7-8 weeks in the first trimester of gestation. 15 pregnant women were examined without disease throughout the entire period of pregnancy. The diagnosis of exacerbation of HCMVI was established by a comprehensive study of peripheral blood for the presence of CMM IgM or a fourfold or more increase in the titer of IgG antibodies in paired sera in dynamics after 10 days to 1: 1600, avidity index more than 65%, and the presence of CMV DNA. The studies were carried out taking into account the requirements of the Helsinki Declaration of the World Medical Association “Ethical Principles for the Conduct of Scientific Research with Human Participation” as amended in 2008 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. Verification of CMV, determination of type-specific antibodies, the avidity index was carried out by ELISA on a Stat-Fax-2100 spectrophotometer (USA) using Vector-Best ZAO test systems (Novosibirsk), by PCR using a DT-96 apparatus using olzovaniem sets NGO "DNA Technology" (Moscow).

6.2. Estrogen receptors were determined in the chorionic homogenate obtained after a medical abortion performed as a result of an exacerbation of HCMVI, i.e., for medical reasons.

6.3. Estrogen receptors (ERα) were determined by enzyme-linked immunosorbent assay on a Stat Fax 2100 spectrophotometer (USA) using kits obtained from BioChem MAK CJSC (Moscow).

6.4. Statistical analysis and data processing was carried out using the software package "Statistica 6.0". Characteristic of the variation series: arithmetic mean (M), standard error (m), coefficient of variation 95%, confidence interval for average values M ± m, where t was determined from the table of boundary values of Student criterion at a confidence level of 95% and the number of degrees of freedom F = n ₁ + n ₂ -2. To determine the significance of differences, unpaired parametric student criterion was used. P <0.05;0.01; 0.001. To determine the significance of differences in the case of non-Gaussian distributions, non-parametric Kolmogorov-Smirnov and Mann-Whitney criteria.

7. Received data

Studies have shown that exacerbation of HCMVI at 7-8 weeks of gestation in the presence of IgG antibodies to CMV 1: 1600 in the chorionic homogenate reduces the content of estrogen receptors (ERα) to 3.62 ± 0.91 nmol / L (control - 10.4 ± 0.95 nmol / L), which poses a threat to normal embryo implantation at 7-8 weeks of gestation.

Example. Pregnant K. Age 25 years old, became pregnant for the first time. At the 7th week of gestation, signs of inflammation of the upper respiratory tract appeared. Laboratory analysis revealed exacerbation of CMVI with a titer of 1: 1600 IgG to CMV. At 8 weeks, the pregnant woman had a miscarriage.

Literature

1. Rosen VB, Smirnov A.N. Receptors and steroid hormones. M .: Publishing. Moscow State University. 1981. 210 p.

2. Crum S.P., Lee K.L. Diagnostic gynecologic and obstetric pathology // Elsevier Saunders. 2006.

3. Farhi J., Weissman A., Steinfeld Z. Estradiol supplementation during the luteal phase may improve the pregnancy rate in patients undergoing in vitro fertilization - embryptransfer cycles // Fertil. Steril. 2000. Vol. 73, No. 4. P. 761-766.

4. Gregory L. Ovarian markers of implantation potential in assisted reproduction // Hum. Reprod. 1998. Vol. 13. Suppl. 4. P. 117-132.

5. Lessey B.A. Two pathways of progesterone action in the human endometrium; implication for implication and contraception // Steroids. 2003. Vol. 68. P. 809-815.

Claims (1)

A method for determining the threat of impaired embryo implantation in the uterine mucosa during exacerbation of cytomegalovirus infection in the first trimester of gestation, characterized in that the titer of IgG antibodies to CMV is determined at 7-8 weeks of pregnancy and the content of active receptors for estrogen (ERα) in the chorionic homogenate is determined, and when determining the titer of IgG antibodies to cytomegalovirus to 1: 1600, reducing the ERα content in the chorionic homogenate to 3.62 ± 0.51 nmol / L, the threat of impaired embryo implantation into the uterine mucosa is determined, which may esti to his death in the form of spontaneous abortion.