Matrix metalloproteinase-2 and placentary dysfunction development in pregnancy with perinatal infection

Abstract

Introduction. The search for a statistically significant link between sFasL and their potential regulators MMP-2 is necessary to optimize the tactics of managing and treating pregnant women with perinatal infections. Purpose. To determine the level of MMP-2 in pregnant with perinatal infections and its role in the development of placental dysfunction. Materials and methods. The study involved examination of 230 pregnant, who were divided into 3 groups (60 people each): Group I with viral (CMV, HSV-1,2,6 types), Group II with bacterial (chlamydia, ureaplasma, mycoplasma) and Group III with mixed infection. Group IV was the control one, and included 50 pregnant with a physiological course of pregnancy. The study implied determination of serum levels of MMP-2 and sFasL, the level of caspase-3 in the placenta, ultrasound was performed by the MINDRAY M7 (China) scanner. The data obtained were statistically processed using the STATISTICA software. Results and discussion. Pregnant women with perinatal infection were found to have a significant increase in sFasL and caspase-3 levels in all the studied groups as compared to corresponding values in the control group (Kruskal-Wallis test, p<0.001). In all groups of pregnant women with perinatal infection the level of MMP-2 in serum was elevated with respect to control values approximately 3-4 times (Kruskal-Wallis test, p <0.05). According to ultrasound data, hypoplasia of placenta was observed in (46.6 ± 6.4)% of cases in Group І and in (30 ± 6.4)% in Group ІІІ. In Groups II and III, placental hyperplasia was detected in (20 ± 5.2)% and (26 ± 5.7)% of cases, respectively. Conclusions. The findings showed that secondary to the impact of perinatal infection among a number of indices in the peripheral blood of pregnant women, a significant role is played by an increase in levels of MMP-2 and sFasL. These indices reflect and determine the induction of apoptotic response from the placenta in this category of pregnant women. The revealed increase in caspase-3 level means that pregnant women with perinatal infections undergo caspase cascade of apoptosis in placental cells. Thus, the obtained results indicate that pregnant women with perinatal infections develop an increase in the level of MMP-2 and activation of the Fas-dependent signaling pathway of programmed cell death, which leads to the launch of a caspase cascade of apoptosis in placental cells. An increase in the loss of placental cells due to apoptosis may be one of the key factors triggering the development of placental dysfunction [10,11] and, as a consequence, unfavorable conditions for fetal development.