The role of immunological factors in the development of abnormal uterine bleeding in women of reproductive age with extragenital disorders

Abstract

The aim of the study was to assess the role of immunological factors in the development of abnormal uterine bleeding in women of reproductive age with extragenital disorders.
 Materials and methods. The study involved 100 women with abnormal uterine bleeding and accompanying extragenital disorders (main group) and 50 somatically healthy women (control group). Autoimmune antibodies to platelets, phagocytic activity of neutrophil granulocytes, concentration of circulating immune complexes (CICs), total level of membranotropic cytotoxic factors, content of CD4+T-helper subpopulations and cytotoxic CD8+T-killer lymphocytes were evaluated as immunological markers.
 Results of the study. The study showed that thrombocytopenia, caused by the presence of autoimmune antibodies to their own platelets, can be one of the pathogenic factors of bleeding in women with AUB. In 41 % of women with AUB, phagocytic reactions were found to be intense, which was expressed by an increase in chemotaxis and adhesion functions, and in 46 % of women by an increase in the absorption capacity of phagocytes. In the main group, 48 % of the examined women had insufficient phagocyte enzymatic activity, which was evidenced by a decrease in the index of completion of phagocytosis. In 79 % of women of the main group, violations of the formation and elimination of circulating immune complexes were detected. The formation of low-molecular-weight CICs in 82 % of women of this cohort contributed to the induction of autoimmune reactions. The total content of membranotropic cytotoxic factors, which was evaluated according to the lymphocytotoxic test, exceeded the reference values in 88 % of women of the main group. In the main group, the average content of CD4+ T-helpers was 23 % lower, and the content of suppressor CD8+ T-lymphocytes was twice as low compared to the control group, resulting in a significant increase in the immunoregulatory index by 30 %.
 Conclusion. The women of the main group with abnormal uterine bleeding were found to have a violation of the functional activity of cellular factors of innate immunity, accompanied by changes in the absorption and digestive capacity of phagocytic cells. Assessment of secondary adaptive reactions showed induction of humoral sensitization and formation of autoimmune reactions (presence of antiplatelet autoantibodies, increase in CICs and LCT, decrease in the subpopulation of CD8+-suppressor T-lymphocytes). The detected violations indicate the pathogenic role of immunological reactions in women with abnormal uterine bleeding