Faculty of Medicine
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Item type:Publication, Connection between cytokines and complications derived from preeclampsia pregnancies(ScopeMed Publishing, 2020-05)Preeclampsia is a condition of multiorgan involvement that can cause severe complications for the mother’s health and endanger the intrauterine development of the fetus. Purpose: The purpose is to detect the risk of developing preeclampsia in the second trimester, by examining cytokines and closely monitoring the pregnancy for complications from preeclampsia, whether they are affected by the same cytokines. Material and methods A total of 100 patients were monitored in the second trimester between 14 and 20 weeks of gestation. Values of immune biomarkers of their serum were analyzed after obtaining anamnestic data and performing ultrasound examination. With the help of the ELISA methodology, cytokines were verified: TNF-a, IL-1a, IL-2, and IL-6 versus IL-4 and IL-10. Results Of the 100 patients examined, 21 patients developed clinical symptoms and were diagnosed with preeclampsia in the third trimester. The interaction of proinflammatory interleukins is in favour of a mutual increase, and a decrease in the values of antiinflammatory interleukins is a significant predictive parameter in the second trimester for the development of preeclampsia. The increase in IL-6 is the largest statistically significant variable in the prediction of preeclampsia. The correlation between IL-6 and pregnancy complications is also with statistical significance (p=0.012). Conclusion The impaired immune response can result in consequences such as multiple organic disorders that occur in the clinical preeclampsia syndrome and problems with fetal development. The benefit of analyzing cytokines is highly significant for early diagnose and prevention of further complications. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Uterine artery pulsatility index as a relevant parameter in the prediction of preeclampsia(Macedonian Pharmaceutical Association, 2020-03); ; Mirjana Kaeva PejkovskaPreeclampsia is a clinical syndrome that occurs in 5-10% of pregnancies with increased perinatal morbidity and mortality. According to ISUOG (International Society of Ultrasound in Obstetrics & Gynecology), the use of the uterine artery pulsatility index (PI) is an important sensitive method in predicting the risk of preeclampsia. This study is to emphasize the value of PI as a more relevant predictive parameter in the detection of preeclampsia in the second trimester compared to the presence of isolated uterine artery notch. For the above purpose, 96 patients were examined at the University Clinic of Gynecology and Obstetrics in Skopje, divided into 2 groups: study and control group. The study group consisted of 48 patients from 14 to 20 gestational weeks with present uterine artery notch, being the main inclusion criterion. The control group consisted of 48 pregnant patients at the same gestational age with absence of uterine artery notch. In the study group, 43.7% developed clinical syndrome of preeclampsia. The resistance index (RI) value was up to 0.73 and the predictive value of the RI was 57.1%. In patients who developed preeclampsia syndrome, the value of the PI above 1.75 was of much greater predictive value, with value of 71.4%. The sensitivity of these values was 88%, which is a reliable parameter. PI is a reliable parameter in detecting the risk of developing preeclampsia and an indicator of great clinical significance in the daily practice in perinatology. - Some of the metrics are blocked by yourconsent settings
Item type:Publication, Correlation between IL-6 (Interleukin 6) and Laboratory Parameters (CRP, Total Proteins and LDH) for Verification of the Inflammatory Origin in Preeclampsia(SHMSHM / AAMD, 2020-03); ; Mirjana Kaeva PejkovskaIn normal pregnancy there is a transfer to the Th2 anti-inflammatory type of immunity, directed toward the fetus and the placenta, whereas in pregnancy complications, such as preeclampsia due to absent transfer, Th1 or proinflammatory immune system is dominated. This article analyzes what are the most important circulating biomarkers created by syncytiotrophoblast that together combined and promote oxidative stress. An increase in proinflammatory and decline in the antiinflammatory cytokine is an imbalance that explains the theory that due to impairement of the immunological response, consequences on the mother's circulation are developed and are reflected in the manifestation of pregnancy complications such as preeclampsia and intrauterine growth restriction. The purpose of the study is to emphasize the importance of the results of the correlation between interleukin 6, measured in the serum of patients from 14 to 20 gestational weeks, with laboratory parameters that are pathognomonic for preeclampsia (LDH, total protein and CRP). This explains the immunological and inflammatory response in preeclampsia serving as a predictor of the condition. For that purpose, the materials and methods that were used were 100 patients examined at the University Clinic of Obstetrics and Gynecology, divided in two groups. The first or examined group consists of 50 patients with notch of the uterine artery present in the second trimester from 14 to 20 gestational weeks. The second, or control group consists of 50 patients with absent notch of the uterine artery. These patients are then referred to the Institute of Immunobiology and Human Genetics at the Faculty of Medicine in Skopje to examine the levels of cytokines, in particular the relationship between the proinflamatory with antiinflammatory cytokines (TNF-α, IL-6 vs. IL-10) using ELISA (enzyme-linked immunosorbent assay) methodology, with Magnetic Luminex Assay multiplex kit. The results between the examined and the controlled group verified an increase in proinflammatory (TNF-α and IL-6) and a decrease in the antiinflamatory cytokine (IL-10), from which the variance of the level IL-6 showed important statistical significance p<0.01. Positive correlation was of great statistical significance between levels of cytokine IL-6 and increased levels of LDH and CRP, and with decreased levels of the total proteins of the preeclamptic patients. (LDH p<0.00001, CRP p<0.025 and total proteins p<0.0012). The role of the inflammatory response is obtained by the correlation of the interleukins in the second trimester and laboratory examinations in the third trimester as a sufficient predictive method in detection in early stages the preeclampsia syndrome.