RU2674159C1 - Method for assessing the threat to the formation of fetal organs with an increase in the placenta content of 11-deoxycortisol in the third trimester of gestation with exacerbation of cytomegalovirus infection - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to medicine and can be used for the diagnosis of impaired development of the fetus against the background of exacerbation of cytomegalovirus infection. Method is carried out by determining the content in the placenta homogenate of 11-deoxycortisol, which suppresses the synthesis of cortisol. Against the background of a rise in the titre of antibodies of class G antibodies to the cytomegalovirus to 1:1,600 in the placenta homogenate, the 11-deoxycortisol up to 600.0±23.0 nmol/l and the cortisol content is reduced to 250.0±12.0 mg/l; control – 540.0±18.0 mg/l.EFFECT: at the same time fetal hypotrophy develops, as the weight of newborns averaged 2,300±35 g.1 cl, 1 ex

Description

1. The technical field to which the invention relates.

The invention relates to medicine, namely to the development of a method for assessing the effect of the content of 11-deoxycortisol in the pregnant placenta against the background of exacerbation of the cytomegalovirus infection gestation in the third trimester.

2. The level of technology

11-deoxycortisol is a hormone of the adrenal cortex, which is a precursor to the hormone cortisol [4]. If 11-deoxycortisol accumulates in the blood, then the cortisol content decreases sharply. Although cortisol does not belong to sex hormones, it plays a large role during pregnancy [3, 5, 7]. Cortisol is considered the main catabolic hormone that provides the necessary level of energy metabolism in the pregnant body [6-8, 10]. Cortisol provides the breakdown of glycogen to glucose, increasing its level in the blood, which is necessary for the body as a nutritional reserve. The normal level of cortisol at the beginning of the first trimester of pregnancy is 206.0 ± 2.35 nmol / L, and in the future, its amount during normal pregnancy increases, reaching 730-850 nmol / L in the third trimester of gestation. Reducing the level of cortisol in the blood of a pregnant woman suppresses the energy work of the mother and fetus, reduces the weight of the fetus due to a lack of energy material in the mother’s body [9]. Fetoplacental insufficiency develops, which affects the formation of the fetus during gestation, which is expressed in fetal malnutrition and a decrease in the weight of the newborn.

In the available literature there are references to the study of the content of 11-deoxycortisol by the radioimmunological method and the method of high performance liquid chromatography in serum and plasma and urine for the diagnosis of diseases of the pituitary-adrenal system [1, 2]. During pregnancy, the content of 11-deoxycortisol is analyzed in the amniotic fluid of the fetus by a radioimmunological method. To study the synthesis of cortisol in the placenta, the content of 11-deoxycortisol is determined by the radioimmunological method in the blood of the umbilical cord and uterine vessels [3]. The disadvantage of the above methods is the long analysis time, the need for expensive recording equipment and reagents: radioactive substances having a short shelf life; compliance with enhanced safety measures associated with radiation risk to personnel and the environment, the complexity of research. Biochemical and immunological methods do not give an idea of the location of the substance.

In contrast to the above prototypes, this work has significant differences: 1. The analysis of the content of 11-deoxycortisol is carried out using an enzyme-linked immunosorbent assay. As a substrate for which 11-deoxycortisol is used. 2. Changes in the content of 11-deoxycortisol occur under the influence of exacerbation of cytomegalovirus infection during pregnancy. The method is simple to implement, does not require expensive reagents, has good resolution and can be recommended for research and laboratory diagnostics.

3. The implementation of the invention

3.1. We examined 37 pregnant women aged 18-25 with exacerbation of chronic cytomegalovirus infection in the third trimester of gestation, the control group consisted of 30 pregnant women with chronic cytomegalovirus infection in the latent stage. In pregnant women, symptomatic cytomegalovirus infection manifested itself as an acute respiratory disease, accompanied by rhinopharyngitis. The clinical diagnosis (exacerbation of chronic cytomegalovirus infection) is established by a comprehensive study of peripheral blood for the presence of cytomegalovirus DNA, IgM or an increase in IgG antibody titer in paired sera by 4 times or more in dynamics after 10 days, as well as an avidity index of more than 65%. The studies are 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.

3.2. CMV verification, determination of type-specific antibodies, avidity index is carried out by ELISA on a Stat-Fax-2100 spectrophotometer (USA) using Vector-Best CJSC test systems (Novosibirsk), CMV DNA is detected by PCR using a DT-96 s using sets of NPO DNA Technology (Moscow).

3.3. The concentration of 11-deoxycortisol in the placenta homogenate was determined by the immunochemical method. The reagent was 11-deoxycortisol (Sigma, USA). At the same time, the cortisol content was also determined by the immunochemical method in the placenta homogenate. The studies were carried out on a Stat-Fax-2100 spectrophotometer (USA).

4. Received data

Studies have shown that with exacerbation of cytomegalovirus infection with a titer of antibodies of class G to CMV in the placenta homogenate, the content of 11-deoxycortisol increased to 600.0 ± 23.0 nmol / L with a significant decrease in cortisol to 250.0 ± 12.0 mg / L; control - 540.0 ± 18.0 mg / l. Thus, with exacerbation of cytomegalovirus infection in the third trimester of gestation, the content of cortisol precursor, 11-deoxycortisol, sharply increases and the content of cortisol decreases. Under the prevailing conditions, the energy exchange in the pregnant woman’s body decreases and the nutrition of the fetus is disturbed, which leads to the formation of hypotrophy in these fruits and the development of placental insufficiency. The weight of newborns decreased to 2300 ± 35.0 g.

Example

Pregnant O. 24 years old. Primipara. In the third trimester, she suffered an exacerbation of cytomegalovirus infection. In peripheral blood, an increase in 11-deoxycortisol to 540 μg / L and a decrease in cortisol to 220 μg / L were noted. Childbirth has passed in time. However, the newborn was weighing 2350 g, that is, the developmental insufficiency of the fetus developed due to a decrease in energy metabolism and the formation of fetoplacental insufficiency.

Literature

1. Velikanova L.I. Laboratory diagnostics of various forms of hyperandrogenism // Directory of the head of the KDL. 2014. No5. S. 26-34.

2. Goncharov NP, Katsiya GV, Butnev V.Yu., Vorontsov VI, Hagundokova LB, Vezeman R. Application of the radio-immune method for determining 11-deoxycortisol to evaluate the function of the pituitary-adrenal cortex system in the conditions of metopyron test // Questions of medical chemistry. 1988.Vol. 34, no. 1, p. 130-134.

3. Clapp J.F., Thabault N.C., Hubel S.A., McLaughlin M.K., Auletta F.J. Ovine placental Cortisol production // Endocrinology. 1982. Vol. Ill, No. 5. P. 1728-1730.

4. 11-deoxycortisol is a corticosteroid hormone in the lamprey. This article has been cited by other articles in PMC.

5. Feng X., Reini S., Richards E., Wood C. Cortisol stimulates proliferation and apoptosis in the late gestation heart: differential effects of mineralocorticoid and glucocorticoid receptors // Amer. J. Physiol. Regul Integr Comp. Physiol. 2013.305: R343-R350.

6. Jensen E., Wood C, Keller - Wood M. The normal increase in adrenal secretion during pregnancy contributes to material volume expansion and fetal homeostasis // J. Soc. Gynecol. Investig 9: 2002.362-371.

7. Jensen E., Wood C, Keller - Wood M. Chronic alteration in ovine material corticosteroid levels influence uterine blood flow and placental and fetal growth // Amer. J. Physiol. Regul. Integr. Sotr. Physiol. 2005.22: R54-R61.

8. Kawai A., Kuzuja N. On the role of glucocorticoid in glucose-induced insulin secretion // Horm Metab. Res. 9: 361-365, 1977.

9. Mommsen T., Vijan M., Moon T. Cortisol in teleosts: dynamics, mechanisms of action and metabolic regulation // Rev Fish Biol. 1999. 9. 211-268.

10. Trainer P. Corticosteroids and pregnancy // Semin Reprod Med. 2002.20: 375-380.

Claims (1)

A method for diagnosing the threat of impaired formation of fetal organs with an increase in 11-deoxycortisol in the placenta against an aggravation in the third trimester of gestation of cytomegalovirus infection, and with a titer of class G antibodies to cytomegalovirus 1: 1600, an increase in the content of 11-deoxycortisol in the placenta homogenate to 600.0 ± 23 , 0 nmol / L and a decrease in its cortisol content to 250.0 ± 12.0 mg / L in the third trimester of gestation, a threat to the formation of the fetus is created, which is manifested in the development of malnutrition and a decrease in the weight of newborns to 2300 ± 35.0 g.