Patologìâ (Aug 2020)
Features of the cytokine profile in the structures of chorion and placenta in premature termination of pregnancy
Abstract
The placenta is a mirror of pregnancy. The formation of a healthy placenta predetermines embryo-endometrial relationships, which are regulated by cytokines. The study of the role of cytokines in the regulation of the gestation process in miscarriage is relevant. The aim of the work is to establish markers of miscarriage based on the study of features of the cytokine profile in the structures of the chorion and placenta in premature termination of pregnancy. Materials and methods. 22 chorions and 26 placentas from women with a history of reproductive loss and termination of current pregnancy were examined (the main group). The control was the tissue of the chorion, taken after artificial abortion in 20 women, and 20 placentas from uncomplicated pregnancy and physiological births in women with the first pregnancy. The placenta was examined according to the protocol (form No. 013-1/0). Expression of TNF-a, CD31/PECAM-1, CD45/T200/LCA in chorion and placenta structures were determined by immunohistochemistry. Results. The termination of pregnancy in the first trimester is accompanied by a violation of the ratio of cytokines - an increase in the expression of TNF-α and a decrease in the expression of CD31/PECAM-1 in the structures of the endometrium and villous chorion. The results indicate a shift in the immunological balance towards an inflammatory response and a violation of the cytotrophoblastic invasion. Inflammation plays a leading role in the development of preterm birth. Structural and functional changes in the placenta against the background of inflammation make up the morphological substrate of chronic placental dysfunction, which, in a case of decompensation, triggers the process of preterm birth. Conclusions. The cytokine marker of terminating pregnancy in the first trimester is the high expression of TNF-α in the structures of chorion and endometrium in combination with low expression of CD31/PECAM-1 in the endothelium of the spiral arteries, in the intravascular and interstitial cytotrophoblast. The marker of inflammation is a moderate expression of TNF- α in the invasive cytotrophoblast, decidual cells and terminal villi of placenta in combination with high expression of CD45/T200/LCA in the decidual membrane.
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