Состояние клеточного иммунитета и цитокинового баланса у беременных женщин при внутриутробном инфицировании

Abstract

The question of studying changes in the immune responses of mother and foetus against the background of infections acquired via various routes remains relevant. This study aimed to assess the state of T-cell immunity and cytokine balance in pregnant women with various pathways of intrauterine infection and the condition of newborns. The study involved 205 pregnant women at high risk for intrauterine infection. In the 1st trimester, bacteriological and DNA analysis of the lower urogenital tract and cytological examination of the cervical canal were performed, blood levels of immunoglobulins M and G for herpes simplex virus type 1 and 2, cytomegalovirus infection, toxoplasmosis, and rubella were determined. In the whole blood of the women, lymphocyte immunophenotyping was performed using CYTO-STAT® triCHROMETM CD8-FITC/CD4-RD1/CD3-FITC monoclonal antibodies; the content of cytokines (IL-6, IL-10) was analysed by means of enzyme-linked immunosorbent assay. After delivery, a pathomorphological examination of the placenta was performed in line with the generally accepted method. According to the results of the study, the following groups of women were identified: 1) without infectious or inflammatory changes (n = 59); 2) with confirmed ascending infection (n = 69); 3) with haematogenous infection (n = 33); 4) with mixed infection (n = 44). The condition of newborns was assessed with the help of laboratory and instrumental methods, using the INTERGROWTH-21st charts and the Apgar score. We found that the functioning of the immune system of pregnant women is affected by viral infections acquired via the haematogenous route, resulting in a relative increase in suppressor T cells and a decrease in helper T cells, as well as ina growing absolute number of lymphocytes in the blood. The identified inhibition of IL-6 and IL-10 production in the groups with signs of placental lesions due to infection at 16–18 weeks can indicate a strain on the immune processes and development of placental insufficiency. Newborns with morphological signs of haematogenous infection are characterized by changes in the cytological parameters of residual cord blood, signs of placental insufficiency, low birth weight, and hypoxic-ischemic damage to the central nervous system.