Метою дослідження була оцінка експресії гена eNOS у
плацентарній тканині при залізодефіцитній анемії. Показано, що у
пацієнток із ЗДА рівень експресії гена eNOS більший в 1,4 раза,
ніж у здорових вагітних, а при поєднанні ЗДА та дисфункції
плаценти рівень експресії гена eNOS менший у 10 разів, ніж у
здорових вагітних. Обговорюється адаптивний характер змін
експресії гена eNOS при залізодефіциті у вагітних. Проведене
зіставлення генетичних та фенотипічних характеристик активності
ферменту ендотеліальної нітроксидази у децидуальній тканині.
Introduction. One of the most urgent problems of modern obstetrics
is the occurrence of iron deficiency in pregnant women. The experts
assess its prevalence in 20–30 % of cases in economically developed
countries and 50–80 % – in developing countries. In Ukraine in the
recent years, the incidence of iron deficiency anemia during pregnancy
increased from 15.0 to 22.6 %. The interest of researchers to the
problem of IDA due to the fact that in this pathological condition
incidence of preeclampsia, preterm labor, polyhydramnios, premature
rupture of membranes, weakness of labor forces and other pregnancy
complications significantly increased. According to experts, the increase
in the amount of blood loss during labor is in 10 % of pregnant women
with IDA. This population of pregnant women has also postpartum
septic complications and hypogalactia. Iron deficiency significantly
worsens overall condition of mother and fetus.
Our aim was to evaluate the gene expression of eNOS in placental
tissue of the pregnant women with iron deficiency anemia.
Material and Methods. Research performed at the maternity
hospital № 2 (Odessa), Genetic Laboratories "Nadiaya" and
pathomorphological department of State Institution "IPOG NAMSU"
(Head, Professor, MD Zadorozhna TD, Kyiv). The study involved 100
women in labor; we took placenta samples from them. Thus, the
following clinical groups were designed: group 1 – the placenta samples
of women with physiological pregnancy and childbirth (n = 20), group 2
– the placenta samples of pregnant women with a history of anemia
(n = 40), group 3 – the placenta of women with placental dysfunction
and a history of anemia (n = 40). In addition to the general clinical
research methods, we used current clinical protocol approved by the
order № 782 dated 29.12.2005 “On approval of clinical protocols for
obstetric and gynecological care”, further research was conducted
analysis of immunohistochemical expression of endothelial nitric
synthase (eNOS) in placental tissue. Age of pregnant women ranged
from 20 to 35 years (28.5 ± 2.8 years).
Discussion. As a result the level of eNOS gene expression increased
by 1.4 folds in patients with IDA, while the combination of IDA and
placental dysfunction eNOS gene expression level reduced by 10 folds.
We discuss the adaptive nature of changes in eNOS gene expression in
iron deficiency amongst pregnant women. There were compared genetic
and phenotypic characteristics of the enzyme activity of endothelial
nitric oxide synthase in decidual tissue. When comparing detected
changes of eNOS gene expression with the phenotypic manifestations
we found that the expression of endothelial nitric oxide synthase in
patients with dysfunction of the placenta in the cytoplasm synticia villi and fetal capillary endothelium and vascular decidua reduced, and the
presence of a combination of placental dysfunction and iron deficiency
anemia occured with the paradoxical increase expression of the enzyme.
Thus, inhibition of eNOS gene expression is a reflection of the
exhaustion of the adaptive capacity of the organism. This circumstance
suggests that routine administration of nitric oxide precursor (L-arginine
medication) in women with gestational endoteliopatiyi manifestations
may not give the desired effect due to the presence of a genetically
determined deficiency of endothelial nitric oxide synthase and its
products. Besides, when isolated iron deficiency anemia occurs than
changes in eNOS gene expression is less evident.
Целью исследования была оценка экспрессии гена eNOS в
плацентарной ткани при железодефицитной анемии. Показано, что
у пациенток с ЖДА уровень экспрессии гена eNOS больше в 1,4
раза, чем у здоровых беременных, а при сочетании ЖДА и
дисфункции плаценты уровень экспрессии гена eNOS меньше в 10
раз, чем у здоровых беременных. Обсуждается адаптивный
характер изменений экспрессии гена eNOS при железодефиците у
беременных. Проведено сопоставление генетических и
фенотипических характеристик активности фермента
эндотелиальной нитроксидазы в децидуальной ткани.
