Cyclooxygenase 2 and prostaglandin E2 in the genesis of pregnancy loss in cytomegalovirus infection

Prostaglandins (PGs), regulated by cyclooxygenase (COX) 2, play a significant role in the development of placental disorders in pathological pregnancy. A review of current literature reveals a lack of evidence demonstrating the involvement of PGs in the pathogenesis of early spontaneous miscarriages associated with cytomegalovirus (CMV) infection. The aim of this study was to investigate the levels of COX-2 and PG E2 in peripheral blood and determine their significance in predicting pregnancy loss during exacerbation of CMV infection at 7-8 weeks gestation. Materials and methods . The study involved 70 patients experiencing an exacerbation of chronic CMV infection at 7-8 weeks of gestation, with 36 patients presenting with a threatened miscarriage (main group) and 34 patients without signs of threatened miscarriage (comparison group). CMV infection was diagnosed based on the presence of M and G class antibodies using enzyme-linked immunosorbent assay (ELISA), as well as CMV DNA detected by polymerase chain reaction. COX-2 levels in mononuclear cell lysates were determined using the "Assay Designs, COX-2" (USA) test systems, and PG E2 concentrations in blood serum were measured using "Cloud-Clone Corp." (USA) kits. Results . Women with exacerbated CMV infection associated with spontaneous miscarriage at 7-8 weeks of gestation exhibited elevated concentrations of COX-2 (23.0±2.20 ng/mL) and PG E2 (850.10±35.0 pg/mL, p<0.001) compared to pregnant women without threatened miscarriage (12.75±1.35 ng/mL and 42.0±2.80 pg/mL, respectively). Conclusion . The findings of this study underscore the significant role of elevated COX-2 and PG E2 concentrations in the pathogenesis of pregnancy loss during exacerbation of CMV infection at 7-8 weeks of gestation. The assessment of COX-2 and PG E2 levels should be considered as a predictive measure for the risk of pregnancy loss during exacerbation of CMV infection.