Blood Serum Of Women Research Articles

Changes in serum levels of pro- and anti-inflammatory cytokines in women with papillomavirus infection before and after therapy”

Papillomavirus infections (PVI) are among the most common sexually transmitted diseases in the young population. A long, sluggish inflammatory process sufficiently worsens adequate preparation for normal pregnancy. Herpesvirus and Chlamydia infections are the most frequent associations with papillomavirus infection. Many authors believe that PVI may cause dysregulation of pro- and anti-inflammatory cytokines revealed in blood serum. Currently, there are no uniform standards for management and treatment of women with papillomavirus infection without pronounced clinical manifestations, in order to prevent morphofunctional disorders of genitourinary system leading to reproductive disorders. However, most authors believe that antiviral and immunomodulatory drugs are the main tool of therapy against expansion of pathogens in the body. The aim of our study was to compare changes in the levels of IL-17, IL-12 p70, IL-12 p40, IL-13 and TGF-p1 in blood serum of women with papillomavirus infection before and after therapy with Inosine pranobex (IP) and Solanum tuberosum (ST). We conducted a survey of 137 patients with papillomavirus infection treated with drugs containing Inosine pranobex and Solanum tuberosum as active substances. The levels of IL-17, IL-12 p70, IL-12 p40, IL-13, and TGF-p1 in blood serum were determined using specific reagents from RD Diagnostics Inc. (USA). Changes in pro- and anti-inflammatory cytokines before therapy were as follows: decreased levels were found for IL-12 p70, p40; increased values were revealed for IL-13, IL-17, and TGF-p1. After the courses of therapy, we have registered the following changes in PVI-infected patients treated with synthetic drug Inosine pranobex (IP): the levels of IL-12 p70, IL-12 p40 were increased, along with decrease in IL-13 and TGF-p1. Meanwhile, ST therapy was associated with increase in IL-12 p70, IL-12 p40, and a decrease in IL-13 and TGF-p 1. With IP therapy, patients with combined HPV + HV infection showed an increase in IL-12 p70, IL-12 p40 and a decrease in IL-13, while TGF-p1 did not change. Following ST therapy, these patients exhibited higher IL-12 p70, IL-12 p40, decreased IL-13, whereas TGF-p 1 remained unchanged. In the group of women with HPV + Chlamydia infection, an increase in IL-12 p70, IL-12 p40 and a decrease in IL-13 and TGF-p1 was associated with IP therapy. An increase in IL-12 p70, IL-12 p40 and a decrease in IL-13 and TGF-p 1 were shown after ST therapy. In all groups of patients, IL-17 remained at high levels after therapy without significant differences between the mentioned subgroups. In the groups of patients treated with IP. we have recorded a general normalization of immune disorders.

Tumor-promoting roles of IL-4 and TGF-β3, their implications in the progression of breast tumors

Immunosuppressive cytokines are the main components of the tumor microenvironment and perform a vital function in controlling the immune response to malignant neoplasms.The objective: to study the influence of interleukin-4 (IL-4) and transforming growth factor-β3 (TGF-β3) on the development of breast tumors in women.Materials and methods. The concentration of cytokines IL-4 and TGF-β3 in blood serum was determined in 40 women with benign breast tumors, 40 women with malignant breast tumors, and 40 healthy patients without breast pathology, who were included in the control group.Breast cancer (BC) patients were divided into two groups; the first group included patients with the II stage of BC, who were considered to have a low level of BC, and the second group included patients with III and IV stages of BC, who were considered to have a high level. The method of solid phase immunoenzymatic analysis was used to determine the level of cytokines.Results. The results showed that women with benign breast tumors (86.82±1.67 pg/ml) had no statistically significant difference in IL-4 levels compared to the control group (88.25±1.56 pg/ml). However, a significantly higher level of IL-4 (P=0.0001) was found in women with BC (97.12±1.84 pg/ml) compared to the control group.In addition, the results showed that the concentration of TGF-β3 did not increase significantly in women with benign breast tumors (80.84±2.88 pg/ml) compared with patients with BC and controls (80.84±2.88 and 87.89±2.41 pg/ml, respectively). However, the level of TGF-β3 was significantly higher (P=0.01) in women with BC compared to the control group.Conclusions. The results of the current study indicate that the concentrations of TGF-β3 and IL-4 in the blood serum of women may be useful predictors for the early detection of breast cancer, as well as serve as a prognostic indicator of its development.

Blood Concentration of Macro- and Microelements in Women Who Are Overweight/Obesity and Their Associations with Serum Biochemistry.

Risk elements in blood matrices can affect human health status through associations with biomarkers at multiple levels. The aim of this study was to analyze 15 macro- and microelements in the blood serum of women with overweight (BMI of ≥25 kg/m2) and obesity (BMI of ≥30 kg/m2) and to examine possible associations with biochemical, liver enzymatic parameters, and markers of oxidative stress. Based on the power calculation, the study involved women (in the postmenopausal stage) with overweight (n = 26) and obesity (n = 22), aged between 50-65 years. Multifrequency bioelectrical impedance analysis was used to measure body composition parameters. Concentrations of elements were determined by inductively coupled plasma optical emission spectrometry, and Hg was measured using cold-vapor atomic absorption spectroscopy. Individuals with obesity, as indicated by a higher BMI, percentage of body fat, and visceral fat area, had elevated serum levels of Ca, Mg, Fe, Al, Sr, Pb, and Hg. Concentrations of Al, Cu, K, Sb, Zn, and Pb significantly affected biochemical and liver function markers in women with overweight or obesity. Elements such as Cu and Al were associated with increased total cholesterol. The correlation analysis between total antioxidant status and Cu, Al, and Ni confirmed associations in both groups. Our findings underscore the importance of addressing excess body weight and obesity in relation to risk elements. The results of the research could be beneficial in identifying potential targets for the treatment or prevention of comorbidities in people with obesity.

Concentration of vitamin D in the blood serum of women and men of different ages in the Ural Federal District in 2020–2022

Currently, the international medical community lacks systematic, scientifically based data concerning status of vitamin D in various age and gender groups of the population. This situation can lead to incorrect identification of risk groups and the choice of suboptimal ways to solve the problem of vitamin D deficiency in the population. Therefore, the purpose of this work was the study of the status of vitamin D in men and women of different ages. Our research was conducted using a unique database containing 263,269 anonymized measurements of vitamin D levels in residents of all constituent entities of the Russian Federation in the Ural Federal District in 2020–2022, freely provided at our disposal by INVITRO-Ural LLC. The results of our calculations show that in the Urals Federal District the lowest level of vitamin D was observed among adolescents of both sexes, which is on average lower than in the oldest age group of 80+ years. This effect is most noticeable in females, in whom the decline in vitamin D levels begins earlier than in boys and also ends earlier. The explanation for this phenomenon may lie in a combination of processes, the most important of which is puberty of the body, accompanied by an intense increase in bone mass and an increase in body mass index. Many scientists and practitioners associate the high prevalence of vitamin D deficiency among adolescents with increased levels of a number of diseases, which can be prevented and/or reduced by using the vitamin D supplements.

Diagnostic Role of Cell-Free miRNAs in Identifying Placenta Accreta Spectrum during First-Trimester Screening.

Placenta accreta spectrum (PAS) is a severe complication of pregnancy associated with excessive invasion of cytotrophoblast cells at the sites of the endometrial-myometrial interface and the myometrium itself in cases of adherent (creta) and invasive (increta and percreta) forms, respectively. This leads to a high risk of massive blood loss, maternal hysterectomy, and preterm birth. Despite advancements in ultrasound protocols and found associations of alpha-fetoprotein, PAPP-A, hCG, PLGF, sFlt-1, IL-8, and IL-33 peripheral blood levels with PAS, there is a high need for an additional non-invasive test to improve the diagnostic accuracy and to select the real PAS from the suspected ones in the first-trimester screening. miRNA signatures of placental tissue, myometrium, and blood plasma from women with PAS in the third trimester of pregnancy, as well as miRNA profiles in exosomes from the blood serum of women in the first trimester with physiologically progressing pregnancy, complicated by PAS or pre-eclampsia, were obtained using deep sequencing. Two logistic regression models were constructed, both featuring statistically significant parameters related to the levels of miR-26a-5p, miR-17-5p, and miR-101-3p, quantified by real-time PCR in native blood serum. These models demonstrated 100% sensitivity in detecting PAS during the first pregnancy screening. These miRNAs were identified as specific markers for PAS, showing significant differences in their blood serum levels during the first trimester in the PAS group compared to those in physiological pregnancies, early- or late-onset pre-eclampsia groups. Furthermore, these miRNAs exhibited differential expression in the PAS placenta and/or myometrium in the third trimester and, according to data from the literature, control angiogenesis. Significant correlations were found between extracellular hsa-miR-101-3p and nuchal translucency thickness, hsa-miR-17-5p and uterine artery pulsatility index, and hsa-miR-26a-5p and hsa-miR-17-5p with PLGF. The developed test system for early non-invasive PAS diagnosis based on the blood serum level of extracellular miR-26a-5p, miR-17-5p, and miR-101-3p can serve as an auxiliary method for first-trimester screening of pregnant women, subject to validation with independent test samples.

Serum magnesium in women with a history of adverse pregnancy outcomes

Aim. To study of serum magnesium in women with a history of adverse pregnancy outcomes.Materials and Methods. 74 women of child-bearing age, subject to voluntary informed consent, participated in a prospective cohort study. The main group (n = 31) included non-pregnant women who had a history of unfavorable gestation outcomes: premature birth, spontaneous miscarriage, habitual miscarriage, undeveloped pregnancy. The comparison group (n = 43) consisted of non-pregnant women with a history of two or more urgent deliveries. In all women, in preparation for pregnancy, the content of serum magnesium was determined by colorimetric method with xylidine blue.Results. 77.6% of women with a burdened obstetric history of miscarriage (the main group) had various menstrual cycle disorders (FIGO, 2018). When analyzing the levels of magnesium in the blood serum of the examined women, it turned out that the obtained indicators in women of both groups corresponded to the established reference range of normal values of serum magnesium levels. At the same time, in the women of the main group, the average magnesium content in the blood serum was significantly lower and was closer to the lower limit of the range of normal values, and in the comparison group – in the middle of the range of normal values: 0.719 (0.672-0.767) mmol/l and 0.844 (0.778-0.922) mmol/l, respectively, p<0.001.The optimal threshold value of the serum magnesium index in the study was 0.796 mmol/l with the sensitivity and specificity of the proposed prognostic model of 80.6% and 81.4%, respectively.Conclusion. Determination of the level of magnesium in the blood serum of women at the stage of pre-pregnancy counseling is of particular importance. Despite the fact that all the examined women had serum magnesium levels within the range of its normal values, significantly lower serum magnesium levels were found in women with adverse pregnancy outcomes in the anamnesis, which necessitates prescribing magnesium-containing medications to such patients at the stage of pregnancy planning. For the prevention of miscarriage within the framework of preconception preparation with serum magnesium values ≤0.796 mmol/l, the intake of organic magnesium salts is recommended.

Evaluation of (Adipsin, adiponectin, and Ghrelin) and some physiological variables in the blood serum of women with polycystic ovary syndrome in Samarra city

Evaluation of (Adipsin, adiponectin, and Ghrelin) and some physiological variables in the blood serum of women with polycystic ovary syndrome in Samarra city

Evaluation of potential prevalence of onconeural antibodies in women with breast cancer.

Aim: To analyse onconeural antibodies in the blood serum of breast cancer patients without neurological symptoms.. Materials and Methods: The study included 48 women with breast cancer. Paraneoplastic Neurologic Syndromes 12 Ag (IgG) Euroline by EUROIMMUN test was used to determine onconeural antibodies: anti-Hu, anti-Yo, anti-Ri, anti-CV2, anti-Ma/anti-Ta, anti-amphiphysin, anti-recoverin, anti-SOX1, anti-tytin, anti-zic4, anti-GAD65 and anti-Tr (DNER). Results: The conducted analysis revealed the presence of onconeural antibodies such as: anti-recoverin, anti-CV2, anti-Zic4, anti-SOX1, anti-MA2/Ta and antititin in blood serum of women with breast cancer. Conclusions: Further analysis may allow the assessment of the possible clinical usefulness of these determinations.

Плацентарні фактори у вагітних з ізольованими вадами серця в плода

The placenta, as a unique and transient organ in humans, ensures the development and protection of the fetus, the expression of angiogenic and antiangiogenic factors and their receptors. The integrity of the fetoplacental endothelial barrier is critical for the development of fetal organs, especially the cardiovascular system. Placental growth factor (PLGF) regulates the morphologic and functional development of the uteroplacental vasculature and can vary with gestational age and in various pathologic conditions of the pregnant woman. Since there is a differential expression of PLGF and soluble form of fms-like tyrosine kinase (sFlt-1) at different gestational ages and their competitive interaction, it is advisable to study their level in the blood of a pregnant woman as indicators of regulation of the placental vascular system in pathological conditions of the woman and fetus. Purpose - to determine the levels of placental factors, namely PLGF and sFlt-1, in the serum of pregnant women with isolated congenital heart disease (CHD) in the fetus to increase the effectiveness of diagnostics and the ability to predict heart diseases. Materials and methods. The work was based on a prospective clinical study of a hospital sample, using the case-control study method, with the evaluation of some clinical and laboratory data in 30 pregnant women with isolated fetal CHD (study group) and 60 pregnant women with a healthy fetus (control group). In order to minimize the influence of various risk factors for fetal heart disease, the criteria for selecting pregnant women with non-syndromic forms of CHD and the control group were defined. Clinical, laboratory and statistical methods were used in the study. The level of angiogenesis indicators in blood serum of pregnant women of both groups was determined by enzyme-linked immunosorbent assay in units of pg/ml in the third trimester of pregnancy. The statistical analysis was carried out using the R software package. ROC analysis and AUC (area under the ROC curve) were used for quantitative interpretation. Differences with p<0.05 were considered statistically significant. Results. According to the results of the study, the age of the women in the study group ranged from 17 to 39 years with a mean of 28.36±5.12, and the age of the women in the control group was 29.63±5.39 (p=0.239). The mean gestational age of women in the study group at enrollment was 28.26±8.45 weeks. The mean PLGF level was 93.73±77.32 pg/mL in the study group and 198.63±168.27 pg/mL in the control group (p=0.002). The average level of sFlt-1 in the blood serum of the women in the study group was 9779.44±5407.53 pg/ml, while in the pregnant women in the control group it was 3124.6±1624.53 (p<0.001). The sFlt/PlGF ratio was 180.9±151.1 in the study group and 15.76±14.7 in the control group (p<0.001). Conclusions. The obtained results in the form of a decrease of the placental growth factor in the blood of pregnant women with congenital heart defects in the fetus and an increase of the antiangiogenic factor in this group in the III trimester compared to a healthy fetus indicate a violation of angiogenesis in the fetoplacental system. Analysis of data on the age of pregnant women of both groups did not reveal a statistically significant difference between them. Due to the usage of multifactor logistic regression model, was created the CHD “risk calculator” which, using the placental factors of the pregnant woman, calculates the probability of the occurrence of a heart defect in fetus. The study was conducted in accordance with the tenets of the Declaration of Helsinki. The local ethics committee approved the study protocol for all participants. Informed consent was obtained from patients. No conflict of interests was declared by the author.

Influence of hypoxic therapy on the content of individual cytokines in women with autoimmune thyroiditis

Background. The high prevalence of autoimmune thyroiditis and the insufficient effectiveness of hormone replacement therapy dictate the need to explore alternative methods of treating the disease. These methods include interval hypoxic therapy, but its effect on the cytokine profile in autoimmune thyroiditis has not been studied enough.
 Aim. To study the effect of interval hypoxic therapy in combination with hormone replacement therapy on cytokine status in autoimmune thyroiditis and hypothyroidism.
 Material and methods. 136 women with primary diagnosed autoimmune thyroiditis and hypothyroidism were examined. Half of them (n=68) received only hormone replacement therapy for 12 months. The rest of the women (n=68), along with sodium levothyroxine, underwent sessions of interval hypoxic therapy (every 3 months for 10 days according to the formula 555). The concentrations of interleukins-4, -6, -8, -10 and tumor necrosis factor in blood serum were determined. To compare the results in groups, KruskalWallis rank univariate analysis and Dunn's test were used. The Wilcoxon t-test was used to compare two related samples.
 Results. Both isolated hormone therapy and its combination with hypoxic therapy did not affect the concentrations of interleukins-4, -8, -10 and tumor necrosis factor in the blood serum of women with initially diagnosed autoimmune thyroiditis and hypothyroidism. However, hypoxic therapy caused a decrease (p=0.0001) in the initially elevated concentration of interleukin-6 to the level of the control group, which did not happen with the isolated intake of levothyroxine sodium.
 Conclusion. The combination of sodium levothyroxine with hypoxic therapy causes a decrease in the level of interleukin-6, which is elevated in women with newly diagnosed autoimmune thyroiditis and hypothyroidism.

The Levels of Pregnancy-Associated Plasma Protein (PAPP-A) and Chorionic Gonadotropin (β-hCG) in the Blood Serum of Women with Hypothyroidism in the 1st Trimester of Pregnancy.

Hypothyroidism occurs in pregnant women at a rate of 0.3% to 3%. The deficiency of thyroid hormones during pregnancy can lead to an increased risk of pregnancy complications and poor health of the child, particularly affecting its psychomotor development due to the intensive growth of the nervous system during gestation. The study attempted to establish the median concentrations of pregnancy-associated plasma protein PAPP-A and the free subunit of human chorionic gonadotropin β-hCG in women with hypothyroidism in the 1st trimester of pregnancy. The study attempted to establish the median concentrations of pregnancy-associated plasma protein PAPP-A and the free subunit of human chorionic gonadotropin β-hCG in women with hypothyroidism in the 1st trimester of pregnancy. The study included 210 pregnant women between 11 and 13.6 weeks of pregnancy; 105 women were diagnosed with hypothyroidism before or during pregnancy, and 105 women of a similar body weight and gestational age had normal thyroid function.The measurements of the pregnancy parameters studied were performed using the DELFIA® Xpress system. Differences in the multiples of the median of the PAPP-A and β-hCG levels between women with hypothyroidism and healthy women were observed. Introducing correction for patients with hypothyroidism during non-invasive biochemical prenatal testing may allow obtaining more reliable results that would be the basis for referral to invasive procedures.

СОДЕРЖАНИЕ МИКРОЭЛЕМЕНТОВ В КРОВИ ПРИ НАРУШЕНИЯХ МЕНСТРУАЛЬНОГО ЦИКЛА У ЖЕНЩИН РЕПРОДУКТИВНОГО ВОЗРАСТА

Among the microelements, calcium, magnesium and phosphorus have the greatest influence on bone tissue. Calcium with phosphorus complement each other in their main function - preservation of the mineral base of bone tissue. The aim of our study was to compare the content of calcium, phosphorus, magnesium in the blood serum in women with menstrual irregularities of the type of secondary amenorrhea, oligomenorrhea, polymenorrhea in reproductive age with healthy young women. Materials and methods. The study group consisted of women of reproductive age who were observed in the clinic of the Simferopol Central Regional Clinical Hospital, Simferopol, during 2018-2020 with menstrual irregularities. The patients were divided into two age groups, early reproductive period (23-34 years) and late reproductive period (35-40 years). Each group is divided into subgroups according to nosology: secondary amenorrhea, oligomenorrhea, polymenorrhea. The control groups included healthy women 23-34 years old (10 people) and 35-40 years old (10 people). For the determination of inorganic phosphorus, calcium. we used a set of reagents for photometric determination in biological fluids
 «Olvex Diagnostics», Russia. An examination was carried out in the Gemotest laboratory, Simferopol. Statistical methods were used to process the results using the STATISTICA 10 program. Research results. When analyzing the average indicators of total calcium in the blood in women with amenorrhea of 23-34 years, it was found that its content was 2.25 ± 0.15 mmol / L, which corresponded to the normal values, but was lower than in the control group (p <0 , 05). The calcium level in IIA and IIIA groups is significantly lower than in healthy women and did not differ from its concentration in the first group. Findings. The blood calcium content in women with menstrual irregularities by the type of secondary amenorrhea was significantly lower than in other groups. No significant decrease in the concentration of phosphorus and magnesium in the blood was found in any group. The mineral balance was impaired in all women with menstrual irregularities.

Glial cell line-derived neurotrophic factor (GDNF) in blood serum and lacrimal fluid of patients with a current depressive episode

BackgroundMany studies indicate a significant role of GDNF in the pathogenesis of the mood disorders, including bipolar disorder (BD) and major depressive disorder (MDD). Potentially, neurotrophic factors in lacrimal fluid (LF) could become biomarkers of various specific disorders. The aim of this study was to assess GDNF levels in LF and blood serum (BS) of patients with a current depressive episode (cDE). MethodsWe studied the glial cell line-derived neurotrophic factor (GDNF) concentration in the LF and BS of 39 healthy controls and 137 patients with a current depressive episode (cDE) (both subgroups members were 20–49 years): BD – 46 patients, MDD – 91 patients. ResultsGDNF concentration in BS of women with MDD was significantly lower than in men. In BD patients, univariate linear regression analysis revealed significant correlations between GDNF concentration in the LF and the use of anxiolytics or antidepressants. These correlations were confirmed by the multivariate linear regression analysis. A significant correlation between GDNF concentrations in the LF and BS was found in controls. LimitationsThe unequal proportion of men in the BD group did not permit adjusting GDNF concentrations for sex. The collected LF was stimulated, which could influence GDNF levels. It should also be noted that the patients included in the study were not treatment- naïve. ConclusionsOur findings suggest that GDNF concentration in LF could be a biomarker of the cDE (both unipolar and bipolar), though the sensitivity of this potential biomarker may be lower in depressive patients with anxiety symptoms.

Hemostasis System and Plasminogen Activity in Retrochorial Hematoma in the First Trimester of Pregnancy.

(1) Background: The components of the fibrinolytic system and its main component, plasminogen, play a key role in the first months of pregnancy. The effect of autoantibodies interacting with plasminogen in the formation of retrochorial hematoma is unknown. The aim of our study was to determine the role of plasminogen and IgA, IgM, and IgG, which bind to plasminogen, in retrochorial hematoma. (2) Methods: Prothrombin time (PT), thrombin time (TT), partial activated thromboplastin time (aPTT), soluble fibrin-monomer complex (SFMC), D-dimer, plasminogen activity (%Plg), plasminogen concentration (Plg), and the levels of IgG (IgG-Plg), IgM (IgM-Plg), IgA (IgA-Plg) interacting with plasminogen were determined in plasma samples of 57 women with normal pregnancy and 16 with retrochorial hematoma. (3) Results: %Plg in plasma samples from women with retrochorial hematoma was significantly lower than in plasma samples from women with normal pregnancy. The diagnostic significance of %Plg in the ROC analysis was AUC = 0.85. A direct correlation was found between aPTT and the level of autologous IgM interacting with plasminogen. (4) Conclusions: A decrease in the activity of plasminogen in the blood serum of women in the first trimester of pregnancy may indicate disturbances in the hemostasis system and the formation of retrochorial hematoma. According to the results of the study, it is possible to recommend the determination of plasminogen activity in the management of pregnant women in gynecological practice.

РОЛЬ ОКСИДАТИВНОГО СТРЕССА В РАЗВИТИИ ВНУТРИПЕЧЁНОЧНОГО ХОЛЕСТАЗА БЕРЕМЕННЫХ И ЕГО АКУШЕРСКИХ И ПЕРИНАТАЛЬНЫХ ОСЛОЖНЕНИЙ

Objective. To determine the significance of oxidative stress in the pathogenesis of obstetric and perinatal complications in pregnant women with different course of intrahepatic cholestasis (IHC). Material and methods. 59 women with IHC of pregnancy and 30 patients without IHC were examined. The total concentration of nitrite and nitrate ions and thiobarbituric reactive substances (TBARS) in the blood serum of women with IHC was determined, their prognostic significance as predictors of maternal and perinatal complications was analyzed. Results. IHC is accompanied by the development of oxidative stress (Р<0.0001) and endothelial dysfunction (Р(U)=0.013). Determination of the concentration of TBARS in the blood serum of women with IHC allows predicting meconium staining of amniotic fluid (TBARS>17.64 µmol/l, Se=75.0%, Sp=84.3%; AUC=0.820; 95% CI 0,698- 0,908; p=0.0007), preterm labour with a symptomatic course of IHC (TBARS>14.25 µmol/l, Se=100.0%, Sp=71.4%; AUC=0.875; 95% CI 0.635-0.979; p=0.002) and the development of respiratory distress-syndrome in children born to patients with IHC (TBARS>17.32 µmol/l, Se=71.4 %, Sp=75.6%; AUC=0.775; 95% CI 0.648-0.874; p=0.0005). Conclusion. Oxidative stress is an essential link in the pathogenesis of IHC and its obstetric and perinatal complications.

Assessment of ovarian reserve and role of its determining factors in patients with endometriomas combined with pelvic inflammatory disease

Resume. Endometriosis affects from 10% to 50% of women of reproductive age and is one of the most common diseases in gynecology. One of its most common kinds – ovarian endometrial cysts – accounts from 17% to 44% of all patients. The aim of the study was to evaluate the parameters of the ovarian reserve in patients with endometriomas combined with pelvic inflammatory disease. Research materials and methods. Two groups of patients were formed: group I included 45 women with endometriomas combined with pelvic inflammatory disease; group II consisted of 45 patients with isolated endometriomas. Generally accepted criteria were used to assess the ovarian reserve: FSH level, AMH > 1.0 n/ml, number of follicles D, volume of both ovaries. Statistical calculations included the method of calculating the odds ratio (OR) and its 95% confidental interval (95% CI).
 Research results and their discussion. The frequency of the decrease in main parameters of the ovarian reserve showed a deviation in two-thirds of cases in women of group I (68.9%), which is 2.2 times more common (p<0.05). AMH parameters showed a deviation by 3.6 times compared to the control group, and by 1.7 times compared to the parameters of group II (p<0.05). The average level of FSH in blood serum of women in group I was 2.0 times higher than the control indicators, and 1.5 times higher than the indicators of patients in group II. The number of antral follicles < 5 in group II was in 22.2% of observations; and in group 1 – in 91.1% (p<0.05). The endometrioma itself demonstrated a significant influence on the parameters of the ovarian reserve: in the case of a significant share of multiple bilateral endometrial cysts (OR=5.65; 95% CI: (1.71-18.67); p<0.05), their large sizes (OR=7.94; 95% CI: (3.0-21.0); p<0.05), combination with pelvic inflammatory disease, (OR=29.42; 95% CI: (6.33 -146.72); p<0.05) and tubo-ovarian tumours (OR=6.96; 95% CI: (1.44-33.51); p<0.05), as well as aggressive consequences during surgical intervention on both ovaries (OR=8.26; 95% CI: (2.65-25.79); p<0.05). Conclusions. About half of the patients with endometriomas combined with pelvic inflammatory disease note a decrease in the ovarian reserve. Statistically reliable factors are multiple and large ovarian endometrial cysts, a combination with recurrent pelvic inflammatory disease, tubo-ovarian tumours and surgical interventions on the ovaries.

INDIVIDUAL-TYPOLOGICAL APPROACH IN EVALUATION OF VITAMIN D CONTENT AND ITS ERGOGENIC EFFECTS IN WOMEN OF REPRODUCTIVE AGE IN PREGRAVIDARY PREPARATION

The development of a new direction in preventive medicine and obstetric practice requires the active development and implementation of effective comprehensive programs to optimize motor activity, increase the functional capabilities of the body and dynamic control of the content of vitamin D in the blood serum of women of reproductive age. Materials and methods. 133 patients aged 20-35 years with normal body weight (70 women of group I) and overweight (63 women of group II) had a consistent increase in the level of motor activity (mobile applications on Android and Apple platforms) by 1 cent for 7 days for 5-7 weeks, which was combined with the appointment of vitamin D (respectively at a dose of 2000 ME/ day and 4000 ME/ day. The evaluation of the effectiveness of pregravidar preparation is given taking into account the dynamics of body weight, as well as the content of 25-hydroxyvitamin D in blood serum [25 (OH)D], total and ionized calcium, phosphorus and parathyroid hormone in comparison with the initial data. Results. In comparison with the initial data after pregravidar preparation using the author's algorithm for increasing motor activity and the appointment of vitamin D, unidirectional positive effects of exercise tolerance and the dynamics of phosphorus-calcium metabolism in both groups were established within the reference values, but with higher serum levels of total and ionized calcium, phosphorus and a decrease in parathyroid hormone in women with normal body weight compared with women with BMI. Conclusions. The combined use of the proposed daily physical activity with the appointment of vitamin D determined an increase in its content in blood serum, a decrease in body weight and an increase in the effectiveness of pregnancy in women with a BMI of up to 52.3%, and in women with normal body weight up to 91.4%. A comparative analysis of the results of vitamin D content and its ergogenic effects in women of reproductive age allows for a consistent centile increase in the daily number of locomotions and the administration of vitamin D up to 10-12 weeks and the approximation of body weight to the upper limit of the regulatory corridor (75-90 cents) in women with BMI, taking into account their personal consent and under dynamic control of calcium-phosphorus metabolism.

Assessment of vitamin D level in women with abnormal uterine bleeding and chronic psychogenic stress

The objective: to study the level of vitamin D (25-hydroxycalciferol – (25(OH)D) in blood serum of women with abnormal uterine bleeding (AUB) and chronic psychogenic stress.Materials and methods. We examined 100 women of reproductive age with AUB and chronic psychogenic stress (basic group) and 50 patients with AUB without psychogenic chronic stress (comparison group). 30 women without AUB and chronic stress were included in the control group. AUB was diagnosis according to the Order No. 353 of the Ministry of Health of Ukraine dated April 13, 2016. The concentration of vitamin D was determined in blood serum in all the women using the ELISA method.Results. The concentration of vitamin D in the blood serum in patients with AUB and chronic psychogenic stress was on 28.01 % lower compared to the controls (p < 0.001), in the patients with AUB without psychogenic chronic stress – 13.94 % (p = 0.045). The number of individuals with optimal concentration of vitamin D in the control group (36.67 %) was in 2.29 times higher compared to the basic group (16.00 %; p=0.03) and in 1.41 times more compared to the comparison group (26.00 %). Suboptimal level of vitamin D had 53.33 % women in the control group, 43.00 % – basic and 58.00 % – comparison one. The rate of persons with deficiency of vitamin D among the patients with AUB and chronic psychogenic stress was in 4.56 times higher compared to the healthy women (41.00 % and 9.00 % individuals, respectively; p = 0.003), and in patients with AUB without chronic stress –1.78 time (16.00 % women).Conclusions. There is the insufficient vitamin D concentration in women with abnormal uterine bleeding which is more severe in the persons with chronic psychogenic stress.

Changes in serum levels of pro- and anti-inflammatory cytokines in women with papillomavirus infection before and after therapy

The group of papillomaviruses is one of the most common viral infections among sexually transmitted diseases in the young population. A long, sluggish inflammatory process significantly worsens adequate pre-gravidar preparation. Along with papillomavirus infection, herpesvirus and chlamydia infections are the most frequent associations. Many authors believe that PVI reveals dysregulation of pro- and anti-inflammatory cytokines in the blood serum. Currently, there are no uniform standards for the management and treatment of women with papillomavirus infection without pronounced clinical manifestations to prevent morphofunctional disorders of the genitourinary system leading to reproductive disorders. But most authors believe that the use of antiviral and immunomodulatory drugs is the main method of therapy against the proliferation of pathogens in the body. The aim of the study was to compare changes in the levels of IL-17, IL-12 p70, IL-12 p40, IL-13 and TFR-β1 in the blood serum of women with papillomavirus infection before and after therapy with Inosine pranobex (IP) and Solanum tuberosum (ST). Materials and methods: a survey of 137 patients with papillomavirus infection treated with drugs with the active substance Inosine pranobex and Solanum tuberosum was conducted. The levels of IL-17, IL-12 p70, IL-12 p40, IL-13, and TFR-β1 in blood serum were determined using specific reagents from R&D Diagnostics Inc. (USA). Results. Changes in pro- and anti-inflammatory cytokines before therapy: decrease — IL-12 p70, p40, increase — IL-13, IL-17 and TFR-β1. After therapy, the following changes were revealed in the group of patients exclusively with PVI infection when using the drug of synthetic origin IP: the levels of IL-12 p70, IL-12 p40 and a decrease in IL-13 and TFR-β1 increased, while with ST therapy: an increase in IL-12 p70, IL-12 p40 and a decrease in IL-13 and TFR-β1. With IP therapy, patients with HPV+HVI registered an increase in IL-12 p70, IL-12 p40 and a decrease in IL-13, while TFR-β1 did not change, and with ST therapy, IL-12 p70, IL-12 p40 also increased and IL-13 decreased, TFR-β1 remained unchanged. In the group of women with HPV+chlamydia infection, an increase in IL-12 p70, IL-12 p40 and a decrease in IL-13 and TFR-β1 with IP therapy, and an increase in IL-12 p70, IL-12 p40 and a decrease in IL-13 and TFR-β1 with ST therapy were shown. In all groups of patients, IL-17 remained high after therapy without a statistically significant difference between the subgroups. In the groups of patients treated with IP, a predominant normalization of the degree of immune disorders was recorded.

Interaction of high-molecular-weight adiponectin concentration in blood serum with the risk of metabolic syndrome in women

Introduction. The development of metabolic syndrome (MS) in patients with abdominal obesity (AO) may be associated with a low level of the adiponectin (AN) - protective adipocytokine. AN circulates in the blood in various molecular forms.The high molecular weight AN is assumed to have greater metabolic activity. It is currently not clear what level of high molecular weight adiponectin (HMWA) in women with AO is associated with MS and its components.The objective was to study the role of high molecular weight adiponectin in the development of metabolic syndrome in women with abdominal obesity.Methods and materials. 302 women with AO and 161 women without AO were examined. MS was diagnosed in 62.3 % of patients.Results. The concentration of total adiponectin (TAN) and HMAN in the blood serum in women with MS was lower than in patients without MS (p<0.05). According to logistic regression analysis, the most significant factors influencing the risk of MS were low concentration of HMAN in the blood, age, and body mass index (p <0.05).Conclusions. It was found that women with AO and HMAN concentration of less than 1.96 μg/ml in the blood had an increased risk of metabolic syndrome.