The indicators of endogenous intoxication in the dynamic of pregnancy in women with HIV infection
Keywords:
different stages of pregnancy, medium-weight molecules, endogenous intoxication, HIV infection
Abstract
Background. Endotoxicosis is a complex pathophysiological process that has a major impact on the mother-placenta-fetus system during pregnancy, and in some cases, is associated with tissue destruction. The human immunodeficiency virus is an aggravating factor that can increase the risk of endotoxicosis during pregnancy. The aim was to assess the level of endogenous intoxication in HIV-positive women during pregnancy by the content of medium-weight molecules in venous blood.
Methods. The severity of endogenous intoxication was assessed by the content of medium-weight molecules (MSM) in pregnant women with a HIV-positive status. The study included 33 women aged 23 to 35 years. The indicators were evaluated at 4 points: 6-12, 18-22, 28-32, and 38-40 weeks of pregnancy. Blood plasma was used as the study material. The MSM content was measured by spectrophotometry at λ =238, 254, 260, and 280 nm, followed by the calculation of the distribution coefficients (238/260, 238/280, 280/254). The MSM fraction content was expressed in optical density units.
Results. A significant increase in the MSM level was found at λ=260 nm and λ=280 nm at 38-40 weeks compared to 28-32 weeks (p<0.05). The content of MSM280 was higher before childbirth compared to 6-12 week pregnancy (p<0.05). The peptide-nucleotide distribution coefficient (238/260 nm), as well as the aromaticity coefficient (238/280 nm) were lower at 38-40 weeks of pregnancy compared with the first trimester of gestation (p<0.05).
Conclusion. The MSM detected at λ=260 nm and 280 nm, as well as the coefficients of aromaticity and the peptide-nucleotide coefficient proved to be sensitive markers for monitoring the level of endogenous intoxication in HIV-positive pregnant women. Measuring MSM in HIV-positive pregnant women can be used not only as an indicator of endogenous intoxication, but also as an indirect indicator of excessive generation of oxygen metabolites and peroxide damage to biological substrates.
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References
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30. Davydenko V.S., Ostankova Yu.V., Shchemelev A.N., Totolyan A.A. Prognostic assessment of the development of hepatotoxicity in HIV-infected individuals during antiretroviral therapy. Clinical laboratory diagnostics. 2024; 69(8): 402-410. doi: https://doi.org/10.51620/0869-2084-2024-69-8-402-410. (In Russian).
31. Yudakova O.V., Grigoriev E.V. Intensity of lipid peroxidation and antioxidant activity, level of medium-weight molecules as indicators of endogenous intoxication in widespread peritonitis. Clinical laboratory diagnostics. 2004; 10: 20. (In Russian).
2. Vitkina T.I. Medium molecules in assessing the level of endogenous intoxication in chronic non-obstructive bronchitis. Health. Medical ecology. Science. 2014; 56(5): 70–72. (In Russian).
3. Todoriko L.D., Eremenchuk I.V., Batranovskaya S.A., Shapovalov V.P. Dynamics of endogenous intoxication indices in multidrug-resistant pulmonary tuberculosis with destructive changes. Actual Infectology. 2014; 5(4): 55–58. (In Russian).
4. Darenskaya M.A., Chugunova E.V., Kolesnikova S.I., Grebenkina L.A., Semenova N.V., Nikitina O.A. et al. Endogenous intoxication and lipid peroxidation indices in the dynamics of α-lipoic acid treatment in men with diabetic nephropathy at the microalbuminuria stage. Clinical Nephrology. 2021; 13(3): 38-43. doi: 10/18565/nephrology.2021.3.38-43. (In Russian).
5. Prokofieva T.V., Polunina O.S., Polunina E.A., Sevostyanova I.V., Voronina P.N. Evaluation of endogenous intoxication based on the study of substances of medium and low molecular weight in patients with myocardial infarction against the background of chronic obstructive pulmonary disease. Medical Council. 2022; 16(17): 106–115. doi: 10.21518/2079-701X-2022-16-17-106-115. (In Russian).
6. Kolesnikov S.I., Ivanov V.V., Semenyuk A.V. Kolesnikova L.I., Faibusheva A.A., Belyaev L.L. Pregnancy and toxicants. Novikov V.D., Gorbachev E.M. (ed.). Novosibirsk: Siberian Publishing company Nauka. 1986. (In Russian).
7. Grits E.S., Sidorenko V.N., Davydovsky A.G. Endogenous intoxication syndrome during pregnancy (pathogenetic mechanisms and laboratory diagnostics). Reproductive health of Belarus. 2009; 4: 37–51. (In Russian).
8. Makarov I.O., Shemanaeva T.V. Modern view on pregnancy management against the background of HIV infection. Obstetrics, Gynecology and Reproduction. 2012; 6(2): 31–34. (In Russian).
9. Rashidova M.A., Sholokhov L.F., Maryanyan A.Yu., Kolesnikova L.I. HIV and pregnancy: realities of the 21st century. Siberian Scientific Medical Journal. 2022; 42(2): 10-17. doi: 10.18699/SSMJ20220202. (In Russian).
10. Kolesnikova L.I., Darenskaya M.A., Grebenkina L.A., Osipova E.V., Dolgikh M.I., Bolotova Ts.Ts. Study of the state of the lipid peroxidation process in women of different ethnic groups with the threat of termination of pregnancy. Bulletin of the East Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences. 2010; 6-2(76): 31-33. (In Russian).
11. Novikova E.A., Semenova N.V., Karacheva A.N., Nikitina O.A., Maryanyan A.Yu., Bairova T.A. et al. Lipid peroxidation products and superoxide dismutase activity in women depending on the level of phosphatidylethanol in the first trimester of pregnancy. Acta Biomedica Scientifica. 2024; 6. (In Russian).
12. Kolesnikova L.I., Kolesnikov S.I., Darenskaya M.A., Grebenkina L.A., Timofeeva E.V., Leshchenko O.Ya. et al. Evaluation of pro- and antioxidant status in women with HIV and coinfection. Therapeutic archive. 2016; 88(11): 17-21. doi: 10.17116/terarkh2016881117-21. (In Russian).
13. Nikitina O.A., Maryanyan A.Yu., Kolesnikova L.I. Oxidative stress in HIV infection and its impact on the female reproductive system and pregnancy. Journal of Obstetrics and Women's Diseases. 2020; 69(4): 61–72. doi: 10.17816/JOWD69461-72. (In Russian).
14. Nikolskaya V.A., Danilchenko Yu.D., Memetova Z.N. Biochemical aspect of consideration of the role of medium-weight molecules in the body. Scientific notes of the V.I. Vernadsky Tauride National University. Series "Biology, Chemistry". 2013; 26(1): 139–145. (In Russian).
15. Parisi F., Fenizia C., Introini A., Zavatta A., Scaccabarozzi C., Biasin M., et.al. The pathophysiological role of estrogens in the initial stages of pregnancy: molecular mechanisms and clinical implications for pregnancy outcome from the periconceptional period to end of the first trimester. Hum Reprod Update. 2023; 2(6): 699-720. doi: 10.1093/humupd/dmad016.
16. Gavrilov VB, Bidula MM, Furmanchuk DA, Konev SV, Aleinikova OV Evaluation of intoxication of the body by the imbalance between accumulation and binding of toxins in blood plasma. Clinical laboratory diagnostics. 2010; 2: 13-17. (In Russian).
17. Semenova N.V., Nikitina O.A., Novikova E.A., Karacheva A.N., Maryanyan A.Yu., et al. Endogenous intoxication indicators in the dynamics of uncomplicated pregnancy. Medium-weight molecules and lipid peroxidation products. Bulletin of Experimental Biology and Medicine. 2024; 178.11: 605-609. (In Russian).
18. Prokopenko V.M., Pavlova N.G., Arutyunyan A.V. Prooxidant and antioxidant systems in placental mitochondria during its dysfunction. Journal of Obstetrics and Women's Diseases. 2010; 59(5): 56-62. (In Russian).
19. Belskaya L.V., Kosenok V.K., Massard J., Zavyalov A.A. The state of lipid peroxidation and endogenous intoxication indicators in patients with lung cancer. Bulletin of the Russian Academy of Medical Sciences. 2016; 4: 313–322. doi: 10.15690/vramn712. (In Russian).
20. Obukhova L.M, Andriianova N.A. The determination of the low and medium molecular weight substances in the blood serum as the additional diagnostic criterion in the cases of lethal poisoning with narcotic drugs. Forensic Medical Expertise. 2014; 57(6): 37 39. (In Russian).
21. Viktorova I.B., Nesterenko A.V., Zimina V.N. Coinfection (HIV infection/tuberculosis) in pregnant women. Tuberculosis and lung diseases. 2015; (12): 8-18. (In Russian).
22. Pogorelova T.N, Gun'ko V.O, Nikashina A.A, Paliyeva N.V, Alliluev I.A, Larichkin A.V. Dysregulation of redox processes in the placenta during its dysfunction. Russian Journal of Human Reproduction. 2019; 25.6:112 118. https://doi.org/10.17116/repro201925061112. (In Russian).
23. Shamova A.K., Zhaksalykova G.E. The impact of HIV infection on the course of pregnancy, birth outcome and health of the newborn and assessment of preventive measures. Medical Journal Astana. 2019; 4(102): 163-168. (In Russian).
24. Pirogova I.A. HIV infection in pregnant women. Bulletin of the Council of Young Scientists and Specialists of the Chelyabinsk Region. 2018; 2 (21): 57-61.
25. Syusyuka V.G. Psychoemotional status and changes in the hormonal profile of pregnant women. Obstetrics and Gynecology. 2016; 5: 76-81. (In Russian).
26. Kornakova N.V., Kolesnikova L.I., Labigina A.V., Petrova V.A., Lazareva L.M., Darenskaya M.A. et al. Characteristics of lipid peroxidation processes - antioxidant protection in women with infertility against the background of hyperprolactinemia. Bulletin of the East Siberian Scientific Center of the Siberian Branch of the Russian Academy of Medical Sciences. 2007. 1(53): 78-80. (In Russian).
27. Jakovljevic B., Novakov-Mikic A., Brkic S., Bogavac M., Tomic S., Miler V. Lipid peroxidation in the first trimester of pregnancy. Matern Fetal Neonatal Med. 2012. № 25(8): 1316-8. doi: 10.3109/14767058.2011.632038.
28. Genich E.V. Patterns of changes in the lipid peroxidation and neuroendocrine regulation systems in HIV-infected women with reproductive disorders. Abstract of a dissertation for the degree of candidate of medical sciences, Irkutsk, 2021; 23. (In Russian).
29. Chernyavskaya O.A. Management of a pregnant patient with marker immunodeficiency and multiple concomitant pathology. Bulletin of the Russian State Medical University. 2017; 1: 48-54. doi: 10.24075/brsmu.2017-01-06.
30. Davydenko V.S., Ostankova Yu.V., Shchemelev A.N., Totolyan A.A. Prognostic assessment of the development of hepatotoxicity in HIV-infected individuals during antiretroviral therapy. Clinical laboratory diagnostics. 2024; 69(8): 402-410. doi: https://doi.org/10.51620/0869-2084-2024-69-8-402-410. (In Russian).
31. Yudakova O.V., Grigoriev E.V. Intensity of lipid peroxidation and antioxidant activity, level of medium-weight molecules as indicators of endogenous intoxication in widespread peritonitis. Clinical laboratory diagnostics. 2004; 10: 20. (In Russian).
Published
2025-06-21
How to Cite
Semenova N. V., Novikova E. A., Nikitina O. A., Kolesnikov S. I., Maryanyan A. Y., Karacheva A. N., Protopopova N. V., Kolesnikova L. I. The indicators of endogenous intoxication in the dynamic of pregnancy in women with HIV infection // Patologicheskaya Fiziologiya i Eksperimental’naya Terapiya (Pathological physiology and experimental therapy). 2025. VOL. 69. № 2. PP. 54–62.
Issue
Section
Original research
