RELATIONSHIP OF CYTOKINE GENE POLYMORPHISMS TO THE UTERINE SCAR AFTER CESAREAN SECTION


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Abstract

Our previous studies revealed the essential role of local inflammation and neoangiogenic processes in the pathogenesis of uterine scar incompetence after prior cesarean section. Objective. To study associations between the basic morphological signs of uterine scar incompetence and cytokine gene polymorphism. Subjects and methods. The study encompassed 160 patients aged 18 to 45 years with a uterine scar after cesarean section. During repeat cesarean section, the scar was excised and the tissues of the scar and adjacent myometrium were histologically studied. All the patients were divided into 2 groups according to the results of a morphological study of myometrial biopsy specimens: 1) 80 patients with defective scars (DS) of the uterus and 2) 80 with its adequate scars. The polymorphism of the IL-6 (-174 C>G) and IL-10 (-819 C>T and -592 C>A) genes was determined. Results. The morphological study of scar tissue showed that the signs of inflammation and neoangiogenesis had the maximum sensitivity with a high specificity in detecting DS. At the same time, the presence of hematoma or signs of disorganization, by having a high specificity, may be used only as a confirmatory test due to its insufficient sensitivity. A study of the distribution of IL-6 alleles and genotypes revealed no significant associations with the status of a scar. An analysis of IL-10 haplotype (-819 C>T and-592 C>A) revealed that in the presence of inflammation, the genotypic frequency of the TA allele was 39 versus 17% in the absence of inflammation (OR=3.02 (1.25—7.29), р=0.01). Scar tissue neoangiogenesis was also more common in carriers of the TA allele (OR=2.55 (1.0— 6.50), p=0.05). Conclusion. The allelic variants of the IL-10 gene were shown to be associated with the formation of DS of the uterus after cesarean section.

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About the authors

G. T SUKHIKH

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

A. E DONNIKOV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

M. I KESOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

Email: m_kesova@oparina4.ru

N. E KAN

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

E. A KOGAN

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

T. A DEMURA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

I. V KLIMANTSEV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

E. Yu AMIRASLANOV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

M. V SANNIKOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

N. A LOMOVA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

O. A SERGUNINA

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

D. D ABRAMOV

ZAO "DNA-Technology Ltd", Moscow

V. V KADOCHNIKOVA

ZAO "DNA-Technology Ltd", Moscow

D. Yu TROFIMOV

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

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