IMPORTANCE OF CYTOKINES IN THE PATHOGENESIS OF PREECLAMPSIA IN PREGNANT WOMEN WITH IRON DEFICIENCY ANEMIA

Abstract

Hypothesis/aims of study. The frequency of hypertension in iron deficiency anemia (IDA) reaches 32-45%. The pathogenesis of pregnancy complicated with anemia and preeclampsia, including immunological aspects, has been little studied. The aim of this study was to clarify the role of general and local cytokine status violations in pregnant women with anemia in the genesis of preeclampsia and to justify the need for inclusion of immunosuppressive agents for the prevention and treatment of preeclampsia. Study design, materials and methods. The cytokine status (IL-1β, IL-6, IL-8, TNFα) and the level of lactoferrin in peripheral blood serum and in extracts of the placental decidual tissue were examined by ELISA in 96 pregnant women with IDA and preeclampsia in the third trimester of gestation. Pregnant women were divided into four groups: 24 with mild anemia, 18 with moderate anemia, 26 with preeclampsia and mild anemia, and 28 with preeclampsia and moderate anemia. Results. It has been shown that preeclampsia, along with IDA, is accompanied by a significant increase in the level of pro-inflammatory cytokines and the acute phase protein lactoferrin at the systemic and, to a greater extent, local level, that is in the decidual membrane of the placenta, in the development of preeclampsia against the background of moderate anemia. The data obtained confirm the involvement of the immune system in the pathogenesis of preeclampsia, one of the triggers of which is the immune imbalance in IDA. A pathogenetic rationale for the use of immunosuppressive therapy for combined pathology is given. Conclusion. The use of placental hormone progesterone as an immunosuppressive drug in terms of substantiating new immunotherapy strategies for the prevention and treatment of preeclampsia is a topical trend in obstetric practice.