Role of organic acids and morpho-immunohistochemical endometrial changes in pathogenesis of non-developing pregnancy

Non-developing pregnancy (NDP) is not only a medical, but also a social problem. There is no single predictor of NDP development, its causes and mechanisms are very complex. In recent years, when discussing the genesis and diagnosis of most obstetric complications, special attention has been paid to proteomic and metabolomic factors. Moreover, organic acids have been studied thoroughly, as they are considered to be markers of energy cell metabolism. The objective of the trial was to determine prognostic significance of organic acids in NDP pathogenesis. Material and Methods. We examined 30 women who were divided into 2 groups: Group 1 (main) consisted of 20 women with NDP, Group 2 (control) included women with a physiological pregnancy, seeking for an abortion. All women underwent immunohistochemical study of endometrium. Besides, high performance liquid chromatography (HPLC) was used to identify organic acids in blood serum and endometrium. We analyzed the content of organic acids in blood serum and endometrium, associated with metabolic disorders of fatty acids, amino acids, as well as being intermediate metabolites in the Krebs cycle. STATISTICA® for Windows, Release 6.0 module package from StatSoft® Inc., USA (2003), serial number AXAR802D898511FA, was used for statistical analysis of the obtained data. Results. Women with NDP demonstrated elevated concentrations of lactic acid and decreased concentrations of pyruvic acid in serum and endometrium if compared with the control group (p=0.05). 4-hydroxy-phenylacetic acid was found in all women with NDP, while in the control group the very acid was not determined. The revealed changes significantly correlated with immunohistochemical changes in endometrium in women with NDP. We observed high expression of chronic endometritis markers (HLA-DR, CD16 and CD20) in the endometrial stroma, decreased expression of VEGF and LIF receptor marker in the epithelium and stroma. Conclusion. Metaboloma indices combined with immunohistochemical characteristics (increased HLA-DR, CD16, CD20 levels, decreased VEGF and LIF expression) can serve as prognostic criteria for prevention of recurrent pregnancy loss.