Chemokine levels in women with threatening abortion
The objective. To study concentrations of chemokines at systemic and local levels in women with threatened abortion. Patients and methods. The examination included 117 pregnant women with the term of gestation 32-36 wks, 60 placentas and 27 amniotic fluid samples were investigated. The basic group comprised patients with clinical signs of threatened abortion at terms of gestation 32-36 wks (n = 83); later the group was divided into two subgroups depending on the outcome of pregnancy: group 1 - patients, whose pregnancy ended with full-term birth (n = 54); group 2 - patients, whose pregnancy ended with preterm birth (n = 29). The control group comprised patients, whose pregnancy was not threatened by abortion at terms of gestation 32-36 wks (n = 34). Concentration of IL-8, RANTES and Fractalkine were detected in extractions of the decidua and in amniotic fluid by the method of solid-phase ELISA using commercial test systems in blood serum samples. Results. As has been found, threatened abortion in the third trimester is characterized by the presence of markers of active herpetic infection types 1 and 2 in blood (33.3% of pregnant women), DNA of Chlamydia trachomatis (29.2% of cases) and Ureaplasma urealyticum (45.8%) in smears from the cervical canal, and also a combination of herpes and chlamydia infection (6.4%). In pregnancy ended with premature birth, active herpetic infection is found in 50% of women. In miscarriage of pregnancy at late terms (32-36 weeks of gestation), elevated levels of RANTES and a decrease of IL-8 in peripheral blood is noted in pregnant women, and also enhanced IL-8 levels in amniotic fluid during delivery. A decrease of IL-8 concentrations in peripheral blood of patients with threatened abortion to less than 15.4 pg/ml permits to predict premature rupture of membranes in both full-term and preterm pregnancy with the accuracy of 86%. Regularities of a change of chemokine concentrations in women with threatened abortion in different types of biological media have been found: the greatest amount of IL-8 is noted in amniotic fluid, RANTES - in blood, Fractalkine - in extractions of the decidua. Conclusion. Development of threatened abortion at terms of 32-36 wks of gestation is associated with a change of chemokine balance and infectious background. Elevated levels of RANTES reflect the mechanism of involvement of NK cells and is a sign of viral infection; increased IL-8 concentrations is a factor of uterine cervix maturation, rupture of membranes, stimulation of birth activity; an increase of the level of Fractalkine in the decidua is indicative of its involvement in the birth act.