Zhyvetska-Denysova A A, Vorobiova I I, Lozova L A, Shamaieva O V, Stryzhak S K
State Institution «Ukrainian Сenter of Maternity and Childhood of the National Аcademy of Мedical Sciences of Ukraine», 8 Platona Mayborody Str., Kyiv, 04050, Ukraine.
Probl Radiac Med Radiobiol. 2024 Dec(29):447-464. doi: 10.33145/2304-8336-2024-29-447-464.
The impact of the environment on human health in modern conditions cannot be underestimated. The study of thepathogenesis of disease is impossible without establishing the factors of destabilization of biological membranes.The article highlighted the problem of lipid peroxidation and antioxidant defense associated with the accumulationof radiocesium in the placenta.
to determine the biochemical markers of miscarriage associated with the accumulation of 137Cs in the placenta.
According to the research design, pregnant women were divided into groups. Group 1included 153 women with reproductive losses in anamnesis and signs of termination of the current pregnancy.Group 2 (control) included 30 women with an uncomplicated pregnancy and medical history. The women of Group1 were divided into subgroups: 1a - in which the pregnancy ended with timely delivery, despite threatening signsof termination; 1b - pregnancy ended in late premature birth; 1c - pregnancy ended in early premature birth.Accumulation of 137Cs with different activity was detected in the placentas of both groups by β-spectrometry. Theeffect of 137Cs is the activation of free radical processes. The strength of oxidative stress was studied by the contentof diene conjugates (DC) and malondialdehyde (MDA) in the blood. The antioxidant capacity was determined by theactivity of catalase, glutathione-S-transferase, and superoxide dismutase (SOD). Biochemical studies were performed using a spectrophotometer «Specol-11» (Germany).
The increase of DC in the 1st trimester by 2.25 times, in the 2nd and 3rd trimesters by 1.25 and 1.5 times indicates the activation of free radical reactions. The trigger for late preterm births is an increase in MDA in the 1sttrimester by 17.4 %. An increase in MDA by 23.4 % in the 1st trimester indicates the risk of early premature birth andintrauterine death of the fetus. A decrease in the activity of SOD in the 1st trimester by 13.0 % can be a predictor ofpremature birth. Decreased activity of SOD by 18.2 % in the 1st trimester indicates decompensation of adaptationmechanisms. As a result of oxidative stress caused by the accumulation of 137Cs in the placenta, the activity of GSTdecreases almost 2 times. In the 1st trimester, catalase activity in the blood of pregnant women of the 1b and 1csubgroups was reduced by 39.2 % and 44.9 %. The dynamics of catalase in the 2nd trimester indicate the activationof adaptive reactions. After 25 weeks, catalase activity is inhibited in pregnant women of subgroups 1b and 1c dueto depletion of antioxidant protection mechanisms. The activity of 137Cs in the placenta above 4.5 Bq/kg causesdepletion of antioxidant mechanisms, which is confirmed by persistent inhibition of catalase and SOD activityagainst the background of high levels of DC and MDA in the blood. Critical for pregnancy is the activity of 137Cs inthe placenta above 10.4 Bq/kg.
The accumulation of 137Cs in the placenta leads to the activation of lipid peroxidation beyond thecapacity of the antioxidant system. Extreme effects depend on the 137Cs activity and placenta compensatory ability.Indicators of MDA, DC, SOD, and catalase are prognostic regarding the power of oxidative stress and pregnancyscenarios.
在现代条件下，环境对人类健康的影响不可低估。若不确定生物膜不稳定因素，就无法研究疾病的发病机制。本文着重探讨了与胎盘放射性铯积累相关的脂质过氧化和抗氧化防御问题。
确定与胎盘137Cs积累相关的流产生化标志物。
根据研究设计，将孕妇分组。第1组包括153名有流产史且有当前妊娠终止迹象的妇女。第2组（对照组）包括30名妊娠过程顺利且无病史的妇女。第1组妇女又分为亚组：1a组——尽管有妊娠终止的威胁迹象，但妊娠以适时分娩告终；1b组——妊娠以晚期早产告终；1c组——妊娠以早期早产告终。通过β能谱法检测两组胎盘内不同活度的137Cs积累情况。137Cs的作用是激活自由基过程。通过检测血液中二烯共轭物（DC）和丙二醛（MDA）的含量来研究氧化应激的强度。通过过氧化氢酶、谷胱甘肽-S-转移酶和超氧化物歧化酶（SOD）的活性来测定抗氧化能力。使用德国“Specol-11”分光光度计进行生化研究。
孕早期DC增加2.25倍，孕中期和晚期分别增加1.25倍和1.5倍，表明自由基反应被激活。晚期早产的触发因素是孕早期MDA增加17.4%。孕早期MDA增加23.4%表明有早期早产和胎儿宫内死亡的风险。孕早期SOD活性降低13.0%可能是早产的一个预测指标。孕早期SOD活性降低18.2%表明适应机制失代偿。由于胎盘内137Cs积累引起的氧化应激，GST活性降低近2倍。在孕早期，1b组和1c组孕妇血液中的过氧化氢酶活性分别降低了39.2%和44.9%。孕中期过氧化氢酶的动态变化表明适应性反应被激活。25周后，由于抗氧化保护机制耗竭，1b组和1c组孕妇的过氧化氢酶活性受到抑制。胎盘内137Cs活度高于4.5 Bq/kg会导致抗氧化机制耗竭，这在血液中DC和MDA水平较高的背景下，过氧化氢酶和SOD活性持续受到抑制得到了证实。对妊娠至关重要的是胎盘内137Cs活度高于10.4 Bq/kg。
胎盘内137Cs的积累导致脂质过氧化的激活超过了抗氧化系统的能力。极端影响取决于137Cs的活度和胎盘的代偿能力。MDA、DC、SOD和过氧化氢酶指标对于氧化应激强度和妊娠结局具有预后意义。
