BACKGROUND
In 50% of cases, habitual miscarriage is associated with idiopathic causes, which are based on disorders in the link of innate immunity. Studying the features of macrophage polarization makes it possible to expand the understanding of the pathogenesis of various obstetric complications in patients with a history of recurrent miscarriage.
OBJECTIVE
To evaluate the expression of STAT1 and STAT3 mRNA by monocytes in women with the threat of miscarriage and recurrent miscarriage in early pregnancy, to identify the features of the expression of STAT1 and STAT3 mRNA by monocytes of women with uncomplicated pregnancy in the early stages under the influence of supernatants of 24-hour cultures of monocytes of pregnant women with the threat of miscarriage pregnancy and recurrent miscarriage.
MATERIAL AND METHODS
We examined 111 women with a threatened miscarriage and a history of recurrent miscarriage (main group) in the early stages of pregnancy (5—12 weeks) and 54 women with an uncomplicated pregnancy and an uncomplicated reproductive history (control group). Peripheral venous blood served as the material for the study; to quantify the expression of STAT1 and STAT3 mRNA by peripheral venous blood monocytes, a quantitative real-time polymerase chain reaction method was used. Real-time quantitative RT-PCR was performed using primers and probes for STAT1, STAT3, and β2-microglobulin as a housekeeping gene (OOO Fractal Bio, Russia). In each sample, the number of copies was determined using a standard curve built using the iCycleriQ software (BIORAD, USA).
RESULTS
An increase in the expression of STAT3 mRNA in monocytes was found in women with RPL compared with the parameters of women in the control group (p=0.004). There were no statistically significant differences in the level of STAT1 mRNA expression in the compared groups (p>0.05). The expression level of STAT1 and STAT3 mRNA in monocytes of women with threatened miscarriage and RPL did not differ depending on the outcome of the current pregnancy (p>0.05 in all cases). During the experiment, both in the group with an uncomplicated course of pregnancy (FB) and in the group with threatened miscarriage and RPL, there were significantly lower levels of STAT1 mRNA expression relative to monocytes of women with an uncomplicated course of pregnancy without stimulation with supernatants (p=0.014 and p=0.003, respectively).
CONCLUSIONS
Insufficient enhancement of the expression of the STAT3 signaling pathway and polarization of monocytes in the M2 population in women with a history of RPL reflects a reduced inflammatory response and an inadequate anti-inflammatory response, which leads to an imbalance in the immune response and produced cytokines and, as a result, creates conditions for insufficient trophoblast invasion, formation of an interruption threat.
