PHENOTYPIC FEATURES OF IMMUNE CELLS IN PREGNANT WOMEN WITH HISTORY OF INFERTILITY
Introduction. Comprehensive clinical and laboratory studies in pregnant women to study the state of their immune system – CD phenotype, including the expression of intracellular cytokines, are relevant and important for the development of surveillance and therapy tactics, especially in cases of history of infertility.
The purpose of the study was to determine the characteristics of the levels of immunocompetent blood cells based on the CD phenotype with the expression of intracellular cytokines in pregnant women with a history of infertility of different genesis.
Materials and methods. Using a FACSCan cell cytofluorimeter (Becton Dickinson, USA) and Becton Dickinson Systems Test (USA) was determined using monoclonal antibodies (MKAbs) to differentiated lymphocyte antigens CD3, CD4, CD8, CD19, CD56, activation markers (HLA-DR, CD25, CD69) and intracellular cytokine expression (IFN-γ, TNF-α IL-4, IL-10) of CD3+CD4+-cells, in 436 non-pregnant (reference group n), 280 healthy pregnant women without complicated history (group N) and 88 pregnant women with a history of infertility of different origins.
Results. Conducted studies of the immune system of pregnant women with endocrine (1 gr.), tubularperitoneal (2 gr.) and combined (endocrine and tubular-peritoneal) (3 gr) infertility in the history revealed a reliable hanging in women with chronic infections (2 gr.), compared to the norm at the non-pregnant, showed statistically higher level CD3+- and CD3+CD4-lymphocytes with a high expression of markers of activation – HLA-DR and CD25, also as well as activations of CD3+CD8+-, NK T CD3+CD4+CD56+- and CD3-CD56+-lymphocytes an expression of antigens hystocompatibility ІІ. It also showed an increase in the functional activity of T-helpers in terms of the production of pro-inflammatory cytokines in comparison with healthy non-pregnant women and with the other two groups, according to the expression data of their respective markers (IFN-γ + and TNF-α +) in the group of pregnant women with tubular-peritoneal infertility in history; expression of anti-inflammatory IL-4 and IL-10 did not differ from the norm in all 3 groups. The phenotypic features of immunocompetent cells in patients with a history of inflammatory infertility, as well as in the other two groups, do not differ from healthy pregnant women at these gestation periods (6-10 weeks), except for a decrease in their levels of CD3+CD4+IL-10+ -lymphocytes, which can be prognostically dangerous for maintaining a normal pro-/anti-inflammatory cytokine balance.
Conclusions. In all examined groups with a complicated anamnesis in the 1st trimester, the studied parameters do not differ from healthy pregnant women at the same terms, but in women with a history of tubular-peritoneal inflammatory gynecological diseases, there is a higher activation of T-killers, T-cytotoxic, killer cells and T-helper/inducers, including those with high intracellular secretion of pro-inflammatory cytokines IFN-γ and TNF-α, with a significant decrease in anti-inflammatory IL-10 compared with the other two groups.