LOCAL FACTORS OF INNATE IMMUNITY IN THE PREDICTION OF PRETERM BIRTH


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Objective. To develop a test system based on gene expression profiling in the cells scraped from the cervical canal in pregnant women with threatened preterm labor (PL) in order to predict preterm birth. Subjects and methods. A total of 125 women aged 19 to 40 years with threatened PL prior to regular labor were examined. Group 1 consisted of 46 pregnant women who had given birth at 22 to 36 weeks’ gestation within 7 days after the examination. Group 2 included 79 women with threatened PL, who had then delivered a baby at full term. In all the patients, the pattern of vaginal microbiocenosis was analyzed by the Femoflor test and the ratios of TLR4, TNF, GATA3, IL1b, IL10, IL18, TNFa, TLR4, and B2M mRNA levels in the cervical canal were determined by real-time reverse-transcription PCR. The findings were analyzed using binary logistic regression. Results. There was a significant decrease in TLR4 mRNA expression levels (p < 0.05) during PL. A binary logistic regression analysis was used to construct a mathematical model determining the likelihood of PL from the expression levels of TLR4 and IL10 gene. There may be PL at a probability greater than or equal to 15% in the next 7 days. The area under the ROC curve was 0.822 (p = 0.01); the sensitivity and specificity at the cut-off point were 100 and 57%, respectively. Conclusion. The ratio of TLR4/IL-10 mRNA levels may be used as a predictor for PL. This prognostic criterion will be able to timely identify groups at high risk for PL and to implement a complete package of therapeutic and preventive measures.

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作者简介

Victor Tyutyunnik

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: tioutiounnik@mail.ru
PhD, MD, the head of the obstetric physiological department Moscow 117997, Ac. Oparina str. 4, Russia

Tatiana Kurchakova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: t_Kurchakova@oparina4.ru
the postgraduate student Moscow 117997, Ac. Oparina str. 4, Russia

Natalia Kan

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: kan-med@mail.ru
PhD, MD, the head of the obstetric observation department Moscow 117997, Ac. Oparina str. 4, Russia

Oksana Nepsha

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: o_nepsha@oparina4.ru
Ph.D., research scientist of the Laboratory of Molecular-genetic methods Moscow 117997, Ac. Oparina str. 4, Russia

Andrey Donnikov

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: a_donnikov@oparina4.ru
Ph.D., Senior Researcher of the Laboratory Of Molecular-genetic Methods Moscow 117997, Ac. Oparina str. 4, Russia

Marzanat Medzhidova

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: marzana-m@yandex.ru
PhD candidate Moscow 117997, Ac. Oparina str. 4, Russia

Diana Kokoeva

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia

Email: dikokoeva@mail.ru
graduate student Moscow 117997, Ac. Oparina str. 4, Russia

参考

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