Pathogenetic aspects of uterine fibroid development in women with ureaplasma infection

Objective. The study objective is to examine pathogenetic role of adaptive response of the immune system in women with uterine fibroid, developed on the background of ureaplasma infection. Material and Methods. A totoal of 265 women with uterine fibroid were enrolled in the trial. The first group consisted of 190 patients with uterine fibroid on the background of ureaplasma infection; the second group included 75 patients with uterine fibroid but without ureaplasma infection; the control group contained 40 healthy women. Urease genes were used for ureaplasma amplification. AmpliSense kit was used for this purpose. AmpliSense PCR kit was used for PCR amplification of DNA; AmpliSense Immunofluorescene kit with sheep chlamydial antiserum marked with fluorescein isothiocyanate was used for chlamydia testing; HSV-2-test, and sandwich ELISA were used to test for genital herpes; PCR technique with outer and inner primers was used to test HVS DNA; immune-enzyme analyser (NIHONKonden) was used to test urogenital candidiasis. The lymphocyte subpopulations (DM+-3, SD+-4, DM+-8, DM+-20) were determined using monoclonal antilymphocyte antibodies in reaction of indirect immunofluorescence modified with poly-D-lysine (Sigma, Germany). The number of interleukin (IL-1p, -2, -4, -6, -8, -10) and tumor necrosis factor alpha were determined with enzyme-linked immunosorbent assay using the Protein contour test systems (St. Petersburg) and «Vector-best» (Novosibirsk, Russia). Results and Discussion. Anaerobic bacteria dominated in vaginal microbiota of women with uterine fibroid on the background of ureaplasmosis. Obvious immunosuppression was observed: reduction of CD3+ and CD4+ lymphocytes expressing CD3-and CD4-receptors; decrease in serum IgA and increase in regulatory cytokine levels with a variety of diverse effects, which led to immunopathology and contributed to the intensification of proliferative activity of the uterus. Conclusion. Obvious immunosuppression of cellular immunity predisposed the development of autoallergic and proliferative processes. Increased production of macrophage cytokines (IL-ip and IL-10), and IL-2 supressed tumor immunity and was a triggering factor of rapidly growthing uterine fibroids. High local IL-10 production disrupts immune surveillance in the myometrium and increases cell proliferation in the myoma node.