Local immune laboratory parameters in acute gestational pyelonephritis in different trimesters of pregnancy before and after treatment

Kholimenko I.M., Konoplja А.A., Shatokhin M.N., Konoplja E.N., Evsegneeva I.V.

Regional budgetary health care institution "Kursk Regional Multidisciplinary Clinical Hospital", Kursk, Russia
Medical center "STOMED", Moscow, Russia
Russian Medical Academy of Continuous Professional Education of Minzdrav of Russia, Moscow, Russia
Kursk State Medical University, Kursk, Russia
First Moscow State Medical University, Moscow, Russia

Introduction. Acute pyelonephritis in pregnancy is a problem of modern medicine, despite significant advances in research of pathogenesis, diagnostic methods and therapy. There is still no specific clarification of the pathogenetic mechanisms occurring at the local level and supporting the inflammatory process in the renal parenchyma in the absence and presence of pregnancy.

Aim: to study immune status parameters at the local level in acute gestational pyelonephritis in different trimesters of gestation before and after treatment.
Material and methods. The study included 140 women (mean age 25.1±4.3 years), divided into groups: comparison group of 20 healthy women, 15 women without kidney pathology in the 1st, 2nd and 3rd trimesters of gestation; main groups - with a verified diagnosis of acute serous pyelonephritis in the 1st, 2nd and 3rd trimesters of pregnancy with basic treatment (15 women in each group), and 2 (groups of 15 women) with acute pyelonephritis in the 2nd and 3rd trimesters of pregnancy with the inclusion of Viferon in the basic therapy. The cytokine spectrum, complement system parameters and the level of secretory immunoglobulin A were studied in urine before and after treatment.
Conclusion. In acute pyelonephritis in all trimesters of pregnancy, especially in the 2nd and 3rd, an increase in the concentration of proinflammatory cytokines was established, with a decrease in anti-inflammatory and sIgA, an imbalance in the complement system indicators, indicating the presence of immune inflammation at the local level. The conducted basic treatment does not normalize most of the altered immune laboratory parameters at the local level in the 2nd and 3rd trimester of pregnancy. The combination of basic treatment with Viferon showed the best corrective effect.