Pathogenetic Aspects of the First Trimester Miscarriage
Abstract
Purpose: To examine the profile of cytokines and gormones in maternal serum of first-trimester pregnancies complicated by threatened abortion (TACP).
Materials and Methods: Serum levels of interleukin-2 and -6, tumor necrosis factor alpha (TNF-alpha), corticotropin-releasing hormone (CRH), activin A, VEGF, sFlt, PGF were measured, by ELISA, in 24 women with TACP and adverse outcome (group IV) and compared with the corresponding levels of 35 women with TACP and successful outcome (group II) and 21 miscarriage (group III) and 26 women with first-trimester uncohreatened abortionmplicated pregnancy (group I) who served as controls. AtteStat 7.3, MedCalc, Microsoft Excel 2003, Statistica 6.0, Spirmen or Wilcoxon test were used for analysis.
Results: IL-2 and -6 were detected lower and TNF-alpha and activin A were detected higher with no significant difference in group I, compared to all other groups. Only TNF-alpha in group II were detected lower with significantly levels, compared to I group. sFlt in all groups was detected lower, compared to I group. VEGF and CRH were detected lower in II and III groups and higher in IV group, compared to I group. PGF was detected higher in III group and lower in II and IV groups, compared to I group.
Summary: In first-trimester TACP with adverse outcome, allteration of maternal angiogenic factors, activin A, IL and CRH levels, compared to first-trimester uncomplicated pregnancy and TACP wihreatened abortionth successful outcome, is relevant to the occurrence of miscarriages.
About the Authors
S. O. Dubrovina
Rostov Scientific Research Institute of Obstetrics and Pediatrics
Russian Federation
Russian Federation
43 Mechnikova st., Rostov-on-Don, 344012
A. M. Maklyuk
Rostov Scientific Research Institute of Obstetrics and Pediatrics
Russian Federation
Russian Federation
43 Mechnikova st., Rostov-on-Don, 344012
V. A. Linde
Rostov Scientific Research Institute of Obstetrics and Pediatrics
Russian Federation
Russian Federation
43 Mechnikova st., Rostov-on-Don, 344012
I. V. Markaryan
Rostov Scientific Research Institute of Obstetrics and Pediatrics
Russian Federation
Russian Federation
43 Mechnikova st., Rostov-on-Don, 344012
References
1. Серова О.Ф., Милованов А.П. Основные патоморфологические причины неразвивающейся беременности и обоснование прегравидарной терапии женщин //Акуш. и гин. – 2001. – №1. – С. 19–23.
2. Jauniaux E., Burton G.J. Pathophysiology of histological changes in early pregnancy loss //Placenta. – 2005. – Vol. 26. – P. 114–123.
3. Aplin J.D. Hypoxia and human placental development //J. Clin. Invest.- 2000.- Vol. 105, №5.- P. 559-560.
4. Geva E., Ginzinger D.G., Zaloudek C.J. et al. Human placental vascular development: vasculogenic and angiogenic (branching and nonbranching) transformation is regulated by vascular endothelial growth factor-A, angiopoietin-1, and angiopoietin-2 //J. Clin. Endocrinol. Metab.- 2002.- Vol. 87, №9.- P. 4213-4224.
5. Vuorela P., Carpen O., Tulppala М., Halmesmaki Е. VEGF, its receptors and the tie receptors in recurrent miscarriage / P. // Mol. Hum. Reprod. – 2000. – Vol. 6. – P. 276–282.
6. Plaiser M., Dennert I., Rost E. et al. Decidual vascularization and the expression of angiogenic growth factors and proteases in first trimester spontaneous abortions //Human reproduction. – 2009. – Vol. 24, N 1. – P. 185–197.
7. Arechavaleta-Velasco F., Koi H., Strauss J.F., Parry S. Viral infection of the trophoblast: time to take a serious look at its role in abnormal implantation and placentation? //J. Reprod. Immunol. – 2002. – Vol. 55. – P. 113–121.
8. Romero R., Chaiworapongsa T., Espinoza J. Micronutrients and intrauterine infection, preterm birth, and the fetal inflammatory response syndrome //J. Nutr. – 2003. – Vol. 133. – P. 16668– 16673.
9. Crocker I.,. Barratt P. S, Kaur M., Baker P.N. The in-vitro characterization of induced apoptosis in placental cytotrophoblasts and syncytiotrophoblasts //Placenta. – 2001. – Vol. 22. – P. 822.
10. Chaouat G., Dubanchet S., Ledee N. Cytokines: Important for implantation? //J. Assist. Reprod. Genet. – 2007. – Vol. 24. – P. 491–505.
11. Gargano J.W., Holzman С., Senagore P. et al. Mid-pregnancy circulating cytokine levels, histologic chorioamnionitis and spontaneous preterm birth //J. Reprod. Immunol. – 2008. – Vol. 79. – P. 100–110.
12. Perni S.C., Vardhana S., Tuttle S.L. et al. Fetal interleukin-1 receptor antagonist gene polymorphism, intra-amniotic interleukin-1beta levels, and history of spontaneous abortion //Am. J. Obstet. Gynecol. –2004. – Vol. 191, N 4. – P. 1318–1323.
13. Vitoratos N., Papadias C., Economou E. et al. Elevated сirculating IL-1β and TNF-аlpha, and unaltered IL-6 in first-trimester pregnancies complicated by threatened abortion with an adverse outcome //Mediators of Inflammation. – 2006. – Article ID 30485, Р. 1-6.
14. Phillips D.J., Jones K.L., Clarke I.J. et al. Activin A: from sometime reproductive factor to genuine cytokine //Vet. Immunol. Immunopathol. – 2005. – Vol. 108, N 1/2. – P. 23–27.
15. Florio P., Severi F.M., Bocchi C. et al. Single serum activin a testing to predict ectopic pregnancy //J. Clin. Endocrinol. Metab. – 2007. – Vol. 92. – P. 1748–1753.
16. Minas V., Jeschke U., Kalantaridou S.N. et al. Abortion is associated with increased expression of FasL in decidual leukocytes and apoptosis of extravillous trophoblasts: a role for CRH and urocortin //Molecular Human Reproduction. –2007. – Vol. 13, N 9 – P. 663–673.
Review
For citations:
Dubrovina S.O., Maklyuk A.M., Linde V.A., Markaryan I.V. Pathogenetic Aspects of the First Trimester Miscarriage. Medical Herald of the South of Russia. 2011;(2):63-68. (In Russ.)
Views:
312
Email this article 