The relationship between Toll-like receptor-4 genes and preeclampsia outcomes.

PURPOSE: The study aimed to analyse the relationship of the rs4986790 locus of the TLR4 gene with the overall risk of preeclampsia, including both its early and late forms. METHODS: The study used standard genetic analysis methods such as DNA extraction, PCR amplification, and genotyping of the rs4986790 locus of the TLR4 gene to assess the association with the development of preeclampsia and peripartal stroke in 207 pregnant women from the southern regions of Kazakhstan from 2016 to 2022, of whom 103 had peripartal stroke on the background of preeclampsia (the main group) and 104 preeclampsia (comparative group). RESULTS: The results of the study demonstrate that the AG and AG + GG genotypes at the rs4986790 locus of the TLR4 gene are significantly associated with an increased risk of developing an early form of preeclampsia. This opens up a new perspective in the identification of genetic markers that can serve as indicators of a tendency to develop preeclampsia in earlier periods of pregnancy. CONCLUSION: It was noted that the rs4986790 locus did not show a statistically significant association with the risk of late preeclampsia. An important aspect of the study revealed the relationship of genotypes with the development of peripartal stroke on the background of preeclampsia. This study offers practical insights for creating targeted genetic screening and personalised treatments for preeclampsia, aiming to improve patient outcomes. To fully understand the molecular mechanisms underlying the identified association, additional research is required to identify deeper molecular pathways and relationships, and to develop new strategies for the prevention and treatment of preeclampsia.

Diagnostic significance of blood lymphocyte activation markers in pre-eclampsia.

The adaptive and innate immune system is important in both initiating and preventing functional disorders during pregnancy, one of which is pre-eclampsia. The research aims to conduct the comparative quantification of selected subpopulations of peripheral blood immunoregulatory cells in pregnant women with pre-eclampsia in the third trimester. The marker receptors CD4, CD8, CD95, CD25, and CD27 and the marker antigen HLA-DR were considered. The screening was performed by flow cytometry with dual phenotyping using phycoerythrin- and fluorescein-isothiocyanate-labeled monoclonal antibodies. Data processing consisted in calculating a likelihood value to assess the statistical significance of the difference between the samples. A statistically significant decrease in the subpopulation titer of T and B lymphocytes with marker receptors CD4, CD8, and CD19 was found in pre-eclampsia patients. In the CD4 carrier T-lymphocyte population, there was an increased expression of the CD25/CD95 activation and apoptosis markers. In the CD8 T-killer population, a decreased representation of the CD27/CD25/CD95 markers of differentiation, activation, and apoptosis was deterministic. The expression pattern of the major histocompatibility complex antigen HLA-DR did not change significantly in normality and pathology. The titer of peripheral natural killer cells carrying the CD56 marker increased in patients with various degrees of disease severity, while the number of CD16 natural killer remained at the level of the control group. The research results suggest that a change in the ratio of the above receptors is a diagnostic indicator for pre-eclampsia.

Acupuncture as an Additional Method of Rehabilitation Post-COVID-19: a randomized controlled trial.

Objectives: The purpose of this study was to evaluate the effectiveness of complex rehabilitation with and without acupuncture in a hospital setting. Methods: A randomized clinical trial was performed at Rehabilitation center "Kamenskoe Plato" in Almaty, Kazakhstan. 160 patients with Post COVID-19 condition were randomly equally divided into an acupuncture with complex rehabilitation methods and a only complex rehabilitation methods group in the period from March 1, 2022 to July 1, 2022. Either groups was performed for an 10-14 days period. The outcome measures were the Bartel index, the Borg scale, Modified Dyspnea Scale and the 6-minute walking test. Adverse events also were monitored and documented. Results: We found statistically significant improvement after the rehabilitation course with acupuncture in the all scales. And in the group without acupuncture, only on two scales MDS and Borg scale. Conclusion: Rehabilitation with acupuncture is possible and effective in patients recovering from post-COVID-19. Our findings may be useful to guide clinicians taking care of patients with post-COVID-19.

Endometrial thickness and live birth rates after IVF: a systematic review.

AIM: This study aims to systematically review the current literature on published studies with data on the clinical significance of endometrial thickness on ultrasound for live birth rates after IVF or intracytoplasmic sperm injection (ICSI). METHODS: An extensive systematic review of PubMed, Web of Science, ScienceDirect, Google Scholar, and Open Gray databases, and following hand-search of the reference list of the included studies was performed. RESULTS: We found 20 eligible studies that evaluated 20 546 patients for endometrial thickness, presented risk factors for decreased endometrial receptivity, and IVF outcomes with fresh and frozen embryo transfer (FET) cycles. The mean age of the patients ranged from 28.86 to 41.03 years. Reported endometrial thickness ranged from <4 mm to >15 mm. The clinical pregnancy rate varied from 9,09% to 61,49% in fresh embryo transfer cycles and from 13,3% to 79,31% in FET cycles. Overall, LBR varied between 4,80% and 48,99% in fresh embryo cycles and between 6.06% and 39,19% in FET cycles. LIMITATIONS: Only English-language studies were included; most studies were from the China region; retrospective study design used in most studies; different ET thresholds, which in turn could significantly alter the correlation with pregnancy outcomes; different IVF procedure protocols in fresh or FET cycles. CONCLUSIONS: IVF outcomes in patients with impaired endometrial receptivity do not depend only on the condition of the endometrium. Risk factors and endometrial thickness significantly affect LBR in fresh and FET cycles.

The effectiveness of micronized progesterone in the complex therapy of 'thin endometry' syndrome.

The article presents the results of examination of 30 patients with a history of miscarriage and 'thin' endometrium in comparison with 20 patients without reproductive loss and the presence of normal endometrial thickness. The dynamics of intracellular production of γ-INF, IL-1 and IL-10 by cytotoxic endometrial lymphocytes was studied by flow cytometry. It was found that before treatment in patients with miscarriage and thin endometrium syndrome there was a significant (12-fold) decrease in the level of CD8+ cytotoxic/suppressor lymphocytes (p < .01), a 2.8-fold decrease in the level of CD56+ cells, and also a sharp inhibition of the level of intracellular production of cytokines - γ-INF (8 times), IL-1 (11 times) and IL-10 (15 times). Against the background of complex therapy, including the elimination of pathogenic pathogens, antiplatelet therapy, intrauterine ultrasound cavitation and personalized hormonal therapy using intravaginal micronized progesterone (Luteina), an increase of endometrial thickness was observed: M-echo from 5.9 ± 0.1 to 10.2 ± 0.2 mm; the frequency of visualization of uterine vessels increased to 80-100%; in the spiral arteries, the pulsation index significantly decreased-PI (1.43 ± 0.04 vs. 0.79 ± 0.06), resistance index RI (0.96 ± 0.05 vs. 0.54 ± 0.04), systolic-diastolic ratio S/D in the uterine (4.5 ± 0.04 vs. 2.3 ± 0.05) and arcuate arteries (3.67 ± 0.04 vs. 2.41 ± 0.02); and there was also a positive dynamics of intracellular cytokine production with a significant (p < .05) increase in the level of IL-1 and IL-10, as well as the level of γ-IFN CD56+ by endometrial lymphocytes.