CURRENT APPROACHES AND NEW RESEARCH IN
MODERN SCIENCES
International scientific-online conference
80
THE PATHOMORPHOLOGICAL SIGNIFICANCE OF HLA-DR
EXPRESSION IN CASES OF GESTATIONAL PYELONEPHRITIS
AMONG PREGNANT WOMEN
Tojiboev Temur Topvoldi o‘gli
assistant, Andijan state medical institute
Adashbekova Muslima Nodirbek qizi
assistant, Andijan state medical institute.
Mamataliyev Avazbek Ruziboyevich
PhD in medical sciences, associate professor, Andijan state medical institute
https://doi.org/10.5281/zenodo.16716630
Relevance of the problem
Gestational pyelonephritis (GP) is one of the most common and high-risk
infectious-inflammatory conditions encountered during pregnancy, posing a
serious threat to both maternal and fetal health. Understanding the role of the
immune system in such cases is crucial for comprehending the pathogenesis of
the disease. From this perspective, assessing the expression of the HLA-DR
molecule—a key component in antigen presentation—provides an opportunity
to better understand the underlying pathomorphological mechanisms of
gestational pyelonephritis.
Objective of the study
To evaluate the level of HLA-DR molecule expression in renal tissues of
pregnant
women
affected
by
gestational
pyelonephritis
using
immunohistochemical methods and to determine its pathomorphological
significance.
Materials and methods
The study included histological and immunohistochemical analysis of
kidney tissue samples from 30 pregnant women who died between 2020 and
2023 due to nephropathology associated with gestational pyelonephritis. HLA-
DR expression was assessed using monoclonal antibodies and standard
immunohistochemical techniques. A control group was composed of kidney
tissues from 10 pregnant women who died from non-nephrological causes.
Results
Histopathological and immunohistochemical analyses revealed significantly
increased HLA-DR expression in the renal tissues of women with gestational
pyelonephritis. High levels of HLA-DR-positive signals were especially observed
in the tubulointerstitial zones, where inflammatory reactions were present. The
expression was predominantly detected in epithelial and immunocompetent
cells, notably macrophages and dendritic cells.
CURRENT APPROACHES AND NEW RESEARCH IN
MODERN SCIENCES
International scientific-online conference
81
When comparing cases, moderate expression levels were noted in primary
(first-time) pyelonephritis, whereas markedly elevated expression was observed
in recurrent or complicated cases. Moreover, a strong correlation was found
between HLA-DR expression and the severity of nephritic inflammation,
interstitial fibrosis, and lymphomononuclear infiltration. These findings suggest
that HLA-DR plays a central role in amplifying inflammation and modulating
immune responses in gestational pyelonephritis.
Conclusion
The data obtained indicate that increased expression of the HLA-DR
molecule in gestational pyelonephritis reflects an active inflammatory and
possibly autoimmune process in the renal tissue. High expression levels of this
biomarker represent an immune dysregulation specific to pregnancy and
highlight its potential involvement in the pathogenesis of the disease.
HLA-DR expression may serve not only as a diagnostic indicator but also as
a valuable marker for assessing disease severity, predicting outcomes, and
guiding the development of targeted immunomodulatory therapies. Evaluating
HLA-DR expression in renal tissues opens new possibilities for devising
individualized treatment strategies for pregnant patients with pyelonephritis.
References:
1.
Redline RW. Placental inflammation. Semin Neonatol. 2004;9(4):265–274.
2.
Koga K, Mor G. Toll-like receptors at the maternal-fetal interface in normal
pregnancy and pregnancy disorders. Am J Reprod Immunol. 2010;63(6):587–
600.
3.
Volgmann T, Ohlinger R, Panzig B. Asymptomatic bacteriuria in
pregnancy—diagnostic and therapeutic aspects. Clin Microbiol Infect.
2005;11(8):687–693.
4.
Petrovic D. Cytokines in normal pregnancy and preeclampsia. Gynecol
Obstet Invest. 2006;62(4):240–246.
5.
Guleria I, Pollard JW. The trophoblast is a component of the innate
immune system during pregnancy. Nat Med. 2000;6(5):589–593.
6.
Abrahams VM et al. The role of TLRs in preterm birth. BJOG. 2005;112
Suppl 1:123–126.
7.
Chetverikova N.G., Malysheva V.K. Immunohistochemical study of HLA
antigens in kidney tissue in pyelonephritis. Patologiya. 2018;2:43–47.
