Особливості CD3+- і CD3+CD4+-клітин периферичної крові на різних термінах вагітності в жінок із безплідністю в анамнезі

Abstract

Infertile marriage is a complex socio-economic problem; the frequency of infertility in Ukraine is 17-20%, which prompts further study of its mechanisms, including immune ones, in order to develop appropriate methods of correction. Purpose - to characterize the phenotypic features of T-cells and their subpopulation of T-helpers (CD3+CD4+) with the expression of intracellular cytokines in women with a history of infertility at different stages of pregnancy. Materials and methods. Relative levels of immunocompetent cells (cl) of blood, including intracellular expression of cytokines CD3+CD4+cells, in 436 non-pregnant (the reference group n) and 514 pregnant women with infertility at the first trimester and the second trimester of pregnancy were determined using a cellular cytofluorimeter and the corresponding test systems. Characteristics of indicators in pregnant women at the different terms in groups were analyzed: a - 4-7 weeks (140 women); b - 8-9 weeks (163 women); c - 10-12 weeks (133 women); d - 13-18 weeks (63 women); e - 19-28 weeks (15 women) compared to the group n and among themselves. Results. The first 12 weeks of pregnancy in women with a history of infertility are characterized by high blood levels of T-helpers (CD3+CD4+-cl), and their activation according to the expression of markers CD25 and HLA-DR, and for 18 weeks - intracellular secretion of pro-inflammatory cytokines IFN-γ + and TNF-α, high expression of anti-inflammatory IL-4 was observed throughout the 27 weeks of follow-up. The percentage of women with high levels in the blood of CD3+CD4+IFN-γ+- and CD3+CD4+TNF-α+-L is the highest during the first 12 weeks, from 13th week these indicators for TNF-α, and with 20th - for IFN-γ do not differ from non-pregnant ones. Since the beginning of pregnancy, the relative number of women with low expression of IL-4 and IL-10 T-helpers has significantly decreased; within 13-18 weeks, the percentage of such pregnant women is significantly increased to the reference group, and such women are the most vulnerable due to the possible weak reaction of the anti-inflammatory link to the state of tolerance. Conclusions. The characteristics of peripheral blood immune system cell levels according to their CD phenotypes and intracellular cytokine expression indicate their participation in pregnancy mechanisms at different stages and individual analysis allows for negative predictions and improvement of pregnancy course in women with a history of infertility. The research was carried out in accordance with the principles of the Helsinki Declaration. The study protocol was approved by the Local Ethics Committee of the participating institution. The informed consent of the patient was obtained for conducting the studies. No conflict of interests was declared by the authors. Keywords: CD-phenotype of immunocompetent cells, intracellular cytokines, pregnant women, history of infertility.