RU2634252C1 - Method for diagnostics of pregnancy interruption on week 7-9 of gestation due to suppressed activity of membrane receptors to progesterone with cytomegalovirus infection exacerbation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: method involves determination of the IgG antibody titer for CMV on week 7-9 of gestation and determination of the receptors for progesterone in the chorion homogenate, and if on week 7-9 of gestation IgG antibody titer for CMV is determined as 1:1600 and the active receptors for progesterone in the chorion homogenate decrease to 14.00±0.85 nmol/l, the threat of pregnancy interruption in a form of a spontaneous abortion is determined.

EFFECT: higher prediction accuracy.

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Description

1. The purpose of the invention is to show that the suppression of the activity of membrane receptors for progesterone during exacerbation at 7-9 weeks of gestation of cytomegalovirus infection creates a threat of termination of pregnancy.

2. The invention relates to medicine, namely to the diagnosis of abortion due to suppression of membrane receptors for progesterone under the influence of exacerbation of cytomegalovirus infection.

3. Disclosure of invention

The first trimester is most responsible for gestation, since during this period the formation of the placenta occurs, the basic structures of the embryo are laid, and the bond of the embryo with the placenta of the mother is strengthened [2-4]. Progesterone is one of the leading hormones in this period, since the process of transformation of the endometrium, necessary for the introduction of blastocytes, depends on it. It affects the vascularization of the placenta and provides relaxation of the myometrium [2, 5-9]. Therefore, progesterone plays a major role in preparing the uterine mucosa for implantation. However, even if there is a sufficient amount of progesterone in the mother's body, the implantation processes will not be carried out if progesterone cannot come into contact with its receptors located on the membrane surface of the cells of the uterine mucosa and decidual cells of the stroma of the mucosa.

4. New technical challenge

To develop a method for diagnosing premature termination of pregnancy due to suppression of the activity of progesterone membrane receptors in the uterine mucosa during exacerbation of cytomegalovirus infection at 7-9 weeks.

5. In the breast cancer №18 from 09/07/2006, p. 1311, heading - Obstetrics [1]. Authors Zaidieva Z.S. and Magometkhanova D.M. illuminate in detail the effect of progesterone on the formation of implantation of the embryo into the mucous membrane of the uterus and the formation of the embryo in the first trimester of gestation. However, neither in the cited work, nor in other literature devoted to this problem, the authors address the issue of the dependence of implantation and embryo development on the decrease in the effectiveness of progesterone on gestation processes while suppressing the activity of membrane receptors for progesterone during exacerbation of cytomegalovirus infection at 7-9 weeks of pregnancy .

6. The implementation of the invention

25 pregnant women aged 18-26 years with chronic cytomegalovirus infection (HCMVI) in the acute stage at 7-9 weeks in the first trimester of gestation were examined. 15 pregnant women were examined without disease throughout their pregnancy.

6.1. The diagnosis of HCMVI was established by a comprehensive study of peripheral blood for the presence of CMV IgM or a fourfold or more increase in the titer of IgG antibodies in paired sera in dynamics after 10 days to 1: 1600, an avidity index of 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 Conducting Research with the 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

CMV verification, determination of type-specific antibodies, avidity index were carried out by ELISA on a Stat-Fax-2100 spectrophotometer (USA) using Vector-Best CJSC test systems (Novosibirsk), PCR methods on a DT-96 apparatus using NPO kits "DNA technology" (Moscow).

6.2. Receptors for progesterone were determined in the chorionic homogenate obtained after a medical abortion performed as a result of exacerbation of HCMVI, that is, for medical reasons.

6.3. Receptors for progesterone were determined by enzyme-linked immunosorbent assay on a Stat-Fax-2100 spectrophotometer (USA) using kits obtained at BioChem MAK CJSC (Moscow).

6.4. Statistical analysis and data processing is 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 the 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, the non-parametric Kolmogorov-Smirnov and Mann-Whitney criteria were used.

Studies have shown that exacerbation of HCMVI at 7–9 weeks of gestation in the presence of IgG antibodies to CMV 1: 1600 in the chorionic homogenate decreases the content of progesterone receptors to 14.0 ± 0.85 nmol / L; control - 18.5 ± 0.95 nmol / l, which poses a threat of abortion.

Example 1. Pregnant O. Age - 23 years. Sick for the first time. At the 7th week of gestation, signs of inflammation of the upper respiratory tract appeared. Immunological analysis and PCR analysis revealed exacerbation of HCMVI with an antibody titer of 1: 1600. At 9 weeks, a pregnant woman had a miscarriage.

7. Received data

Studies have shown that exacerbation of HCMVI at 7-9 weeks of gestation with a titer of antibodies to CMV of 1: 1600 leads to a decrease in the activity of progesterone receptors in the chorionic homogenate to 14.00 ± 0.85 nmol / L, control - 18.5 ± 0, 95 nmol / l, which creates a threat of termination of pregnancy in the form of spontaneous miscarriage.

Example 2. Pregnant O. Age - 23 years. She got nasopharyngitis. At 7–9 weeks of pregnancy, signs of exacerbation of cytomegalovirus infection appeared - the titer of IgG antibodies to CMV increased to 1: 1600. At 9 weeks, a pregnant woman had a miscarriage. In the chorionic homogenate, a decrease in progesterone receptor activity was noted — 14.00 ± 1.7 nmol / L. Therefore, exacerbation of cytomegalovirus infection at 7 weeks of gestation leads to a decrease in progesterone receptor activity and leads to spontaneous miscarriage.

Example 3. Pregnant M. Age - 21 years. Sick at 6 weeks of gestation with inflammation of the upper respiratory tract. There were signs of exacerbation of cytomegalovirus infection with a titer of IgG antibodies to CMV up to 1: 1600. At week 7, a miscarriage occurred. The chorionic homogenate showed a decrease in progesterone receptor activity to 13.7 ± 1.9 nmol / L. Control - 18.5 ± 0.95 nmol / L. An exacerbation of cytomegalovirus infection and a decrease in the activity of progesterone receptors is a threat at the 7th week of gestation to spontaneous miscarriage.

Literature

1. Zaydieva Z.S., Magometkhanova D.M. Breast cancer №18 from 09/07/2006 S. 1311 (series - Obstetrics).

2. Kulakov V.I., Ordzhonikidze N.V., Tyutyunnik V.L. Placental insufficiency and infection. M., 2004.494 s.

3. Sidelnikova V.M. Habitual loss of pregnancy. M .: Triad-X. 2002.304 p.

4. Sidelnikova V.M., Sukhikh G.T. Miscarriage. M .: MIA. 2010.534 s.

5. Smirnov A.N. Molecular biology of progesterone // Ros. Chem. Journal of the Society D.I. Mendeleev. 2005. T. XLIX, No. 1. S. 64-74.

6. Sukhikh G.T., Vanko L.V. Immunology of pregnancy. M .: Publishing. RAMS. 2003.400 p.

7. Bick R.L., Madden I., Heller K.B., Toofanin A. Recurrent miscarriage: causes, evaluation and treatment // Medseape women's Healft. 1998. Vol. 3, No. 3. P. 2-13.

8. Choi B.C., Polgar K., Xiao L. Progesteroned inhibits in vitro embryotoxic Th1 cytokine production to trophoblast in women with recurrent pregnancy loss // Hum. Reporal 2000. Vol. 15. P. 46-59.

9. Szekeres-Bartho I. Progesterone receptor-mediated immunomodulation and anti-abortive effects: The role of PIBF // Ginecologycal Endocrinology. 2001. Vol. 15, No. 5. P. 43-47.

Claims (1)

A method for determining the threat of termination of pregnancy at 7-9 weeks of gestation due to suppression of the activity of membrane receptors for progesterone during exacerbation of cytomegalovirus infection, comprising determining the titer of IgG antibodies to CMV at 7-9 weeks of pregnancy and determining receptors for progesterone in the chorionic homogenate, and when determining at 7 -9 weeks of gestation of the titer of IgG antibodies to CMV 1: 1600 and a decrease in the chorionic homogenate of active progesterone receptors to 14.00 ± 0.85 nmol / L determine the threat of termination of pregnancy in the form of spontaneous miscarriage.