Rationale for therapy in patients with persistent viral infections during pregravid preparation

Markelova E.V., Tulupova M.S., Nevezhkina T.A., Knysh S.V., Matyushkina L.S.

1) Pacific State Medical University, Ministry of Health of the Russian Federation, Vladivostok, Russia; 2) Paracelsus Medical Center, Vladivostok, Russia
Pregravid preparation is a long and complex therapeutic and diagnostic process related, among other things, to the elimination of the impact of chronic viral infections on the patient's body. A special role is played by herpetic and papillomavirus infections as a factor that increases the risk of not only a negative result of pregravid preparation, but also the development of malignant neoplasms. The effect of these viruses on the immune system as both monoinfections and mixed infections in combination with other viruses is unambiguously negative; however, it is characterized by a number of features that there is no consensus about.
Objective. To comprehensively assess humoral immunity responses in women with persistent viral infections during pregravid preparation.
Subjects and methods. A total of 149 young patients divided into 2 groups (a study group and a control group) according to human papillomavirus infection underwent estimation of the serum levels of cytokines (IL-10, IL-17), transforming growth factors (TGF-α, TGF-β1, TGF-β2), interferons IFN-β, IFN-γ, IFN-λ1 (IL-29), IFN-λ3 (IL-28), metalloproteinases (MMP-2, MMP-8, MMP-9) and their tissue inhibitors (TIMP-1, TIMP-2, TIMP-3).
Results. The authors established a multidirectional change in the level of pro- and anti-inflammatory cytokines in serum, as well as hyperproduction of transforming growth factors, metalloproteinases and their inhibitors. The article separately highlights the role of interferons and also discusses the potential possibility of therapy with interferon inducers in patients with persistent viral infections during pregravid preparation.
Conclusion. The revealed abnormal levels of pro- and anti-inflammatory cytokines, transforming growth factors, and metalloproteinases confirm that there is a difference in the characteristics of an immune response in young women during pregravid preparation, depending on which viral infections are detected in patients. Taking into account the findings, the authors consider it possible to use interferon inducers in the treatment of patients with persistent viral infections, especially in those with mixed infections.


pregravid preparation
human papillomavirus
matrix metaloproteinases
tissue inhibitors


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Received 03.02.2021

Accepted 16.02.2021

About the Authors

Elena V. Markelova, Dr. Med. Sci., Professor, Head of the Department of Normal and Pathological Physiology, Pacific State Medical University, Ministry of Health of Russia, Vladivostok. E-mail: markev2010@mail.ru. ORCID: 0000-0001-5846-851X. 690002, Russia, Primorsky Krai, Vladivostok, Ostryakov Ave. 2.
Marina S. Tulupova, Cand. Med. Sci., obstetrician-gynecologist, Head physician, Paracelsus Medical Center. E-mail: paracels.kdmc@yandex.ru. ORCID: 0000-0003-1017-6299.
690005, Россия, Russia, Primorsky Krai, Vladivostok, Novoivanovskaya str., 4А.
Tatyana A. Nevezhkina, Assistant of the Department of Normal and Pathological Physiology, Pacific State Medical University, Ministry of Health of Russia, Vladivostok.
E-mail: www.tanya.ru9292@mail.ru. ORCID: 0000-0002-9165-3511. 690002, Russia, Primorsky Krai, Vladivostok, Ostryakov Ave. 2.
Sergey V. Knysh, Cand. Med. Sci., Assistant of the Department of Normal and Pathological Physiology, Pacific State Medical University, Ministry of Health of Russia, Vladivostok. E-mail: sergio_knish@mail.ru. ORCID: 0000-0003-4571-1749. 690002, Russia, Primorsky Krai, Vladivostok, Ostryakov Ave. 2.
Lyudmila S. Matyushkina, Cand. Med. Sci., Assistant professor, Head of the Department of Obstetrics and Gynecology, Pacific State Medical University,
Ministry of Health of Russia, Vladivostok. E-mail: doctor-lsm@yandex.ru. ORCID: 0000-0002-5404-4215. 690002, Russia, Primorsky Krai, Vladivostok, Ostryakov Ave. 2.

For citation: Markelova E.V., Tulupova M.S., Nevezhkina T.A., Knysh S.V., Matyushkina L.S. Rationale for therapy in patients with persistent viral infections during pregravid preparation.
Akusherstvo i Ginekologiya/ Obstetrics and Gynecology. 2021; 2: 142-148 (in Russian)

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