Extracellular vesicles (EVs) are double-membrane vesicles that facilitate intercellular communication and play a pivotal role in both physiological and pathological processes. A substantial body of evidence suggests that EVs play a role in the pathogenesis of various pregnancy complications. Because EVs can be detected in the peripheral blood, they are potential biomarkers for the early diagnosis of pregnancy complications and foetal developmental disorders. The majority of studies have demonstrated a correlation between alterations in the concentration of EVs and changes in their contents and the occurrence of pregnancy complications. Despite the current limitations in establishing a clear link between these findings and the pathogenesis of the disease, as well as the lack of sufficient evidence to support their use in clinical practice, it is noteworthy to highlight the potential role of specific miRNAs carried by EVs in the development of pregnancy complications. These include miR-210 and miR-136-5p for pre-eclampsia and gestational diabetes mellitus, miR-155, miR-26b-5p, miR-181a-5p, miR-495 and miR-374c for pre-eclampsia and preterm birth. The following miRNAs have been identified as potential biomarkers for preterm birth and gestational diabetes mellitus: miR-197-3p and miR-520h, miR-1323, miR-342-3p, miR-132-3p, miR-182-3p, miR-517-3p, miR-222-3p, miR-16-5p and miR-126-3p. Additionally, miR-127-3p has been linked to foetal growth restriction and preterm birth. Nevertheless, it would be premature to propose that EVs can be employed as biomarkers for pregnancy complications. Further research and the accumulation of results obtained using the methods proposed in the MISEV2023 guidelines will enable a definitive conclusion to be reached.

Introduction. Currently, non-invasive prenatal testing (NIPT) is widely used to assess a risk of fetal chromosomal anomalies. NIPТ accuracy depends on the cell-free fetal DNA (cffDNA) percentage relative to total cell-free DNA in the pregnant woman's blood (cfDNA fetal fraction, FF). Despite numerous studies, no consensus regarding FF-affecting factors has been reached yet.Aim: to investigate a relationship between FF and clinical-anamnestic parameters of pregnant women, pregnancy characteristics, and outcomes using the developed NIPТ technology.Materials and Methods. A prospective observational study was performed by assessing plasma samples from 5459 women with > 9 week-long singleton pregnancies. NIPТ was performed using semiconductor sequencing followed by bioinformatics data processing, including FF determination, according to a previously developed original algorithm.Results. Median FF was 11.7 [9.5–14.0] %. It was demonstrated that FF depends on blood collection tube type (p < 0.05). FF was found to decrease with woman age and body mass index, and increase with gestational age, elevated early prenatal screening (EPS) biochemical markers – pregnancy-associated plasma protein-A (РАРР-А) and free beta-subunit of human chorionic gonadotropin (β-hCG) levels (p < 0.05). It has been shown that the FF in pregnant women with trisomy 18 is lower than normal (p < 0.05). An increase in FF was observed in pregnant women with fetal congenital anomalies according to ultrasound results (p < 0.05). No association was found between FF and the conception type, first-trimester ultrasound parameters (nuchal translucency, crown-rump length, ultrasound chromosome anomalies markers), fetal trisomy 13 and 21, fetal sex chromosome anomalies, or pregnancy complications – preeclampsia, gestational diabetes, preterm birth, and fetal growth restriction (p > 0.05).Conclusion. The identified patterns are important to take into consideration while using and interpreting NIPТ.

Background: Pre-eclampsia (PE) is a serious condition affecting 2–8% of pregnancies worldwide, leading to high maternal and fetal morbidity and mortality. MicroRNAs (miRNAs), small non-coding RNA molecules, have emerged as potential biomarkers for various pregnancy-related pathologies, including PE. MiRNAs in plasma and serum have been extensively studied, but urinary miRNAs remain underexplored, especially during early pregnancy. This study aimed to investigate the urinary miRNA expression profiles in women with pre-eclampsia during the first and second trimesters. Materials and Methods: A prospective study was conducted using 48 urine samples from 24 pregnant women (n = 12 pre-eclampsia and n = 12 controls). Urine samples were collected in the first (9–13 weeks) and second (22–24 weeks) trimesters. MiRNA isolation, library preparation, and high-throughput sequencing were performed, followed by differential expression and enrichment analyses. Results: In the first trimester, five miRNAs were dysregulated in PE in comparison with the control group (hsa-miR-184, hsa-miR-203a-3p, hsa-miR-205-5p, hsa-miR-223-3p—downregulated; hsa-miR-1-3p—upregulated). In the second trimester, hsa-miR-205-5p and hsa-miR-223-3p were downregulated, and hsa-miR-9-5p, hsa-miR-1-3p, and hsa-miR-206 were upregulated. Conclusions: Our study identified differentially expressed miRNAs in the urine of pre-eclamptic patients during early pregnancy. These findings suggest that specific urinary miRNAs could serve as non-invasive biomarkers for the early detection and risk assessment of pre-eclampsia. The changes in the level of differential expression of miRNAs during gestation highlight their role in the progression of PE. Further research and validation with a larger cohort are needed to explore their clinical potential for improving maternal and fetal outcomes through early intervention.

The article highlights the experience of the "Genofund" biobank of the Ott Research Institute of Obstetrics, Gynecology and Reproductology in bioresource collection in modern obstetrics. To create different types of collections, the following different biobanking strategies were formulated for the first time: cross-sectional and longitudinal (dynamic). Definitions are given for these approaches. The most significant advantages and disadvantages of each of them are noted. Examples of pilot studies conducted on the platform of a bioresource collection created using the complex longitudinal biobanking are given. This approach made it possible to demonstrate, using the example of microRNA analysis, the potential of studying the physiological changes during pregnancy at the present stage, as well as the prospects for finding early predictors of pregnancy complications.

Background: Clozapine remains the only antipsychotic with proven efficacy in treatment-resistant schizophrenia (TRS). However, it is effective in only about 40% of patients and is associated with numerous adverse drug reactions. Personalization of clozapine therapy is therefore of critical importance in clinical psychiatry. MiRNA expression may serve as a promising exploratory marker for understanding individual variability in clozapine efficacy and safety. Methods: In this study, we determined the complete miRNA expression profile in TRS patients before initiation of clozapine and after four weeks of treatment. Results: In 15 inpatients with TRS receiving 4-week clozapine monotherapy, PANSS total decreased from 98.8 ± 13.19 to 80.47 ± 14.63 (p = 0.001). The most frequent adverse drug reactions were hypersalivation (n = 13), drowsiness/sedation (n = 12), and prolonged sleep (n = 12). We detected 24 differentially expressed miRNAs after clozapine. Changes in hsa-miR-129-5p, hsa-miR-6068, and hsa-miR-6814-5p correlated with improvements in positive symptoms; hsa-miR-128-1-5p tracked general psychopathology; and hsa-miR-6814-5p aligned with global improvement (lower PANSS total, higher PSP). Safety signals included associations of hsa-miR-4472 with asthenia/fatigue and prolonged sleep, hsa-miR-4510 with prolonged sleep, hsa-miR-615-3p and hsa-miR-4715-3p with tachycardia, and hsa-miR-329-1-5p with weight gain. Conclusions: Because miRNAs regulate the expression of a wide range of genes, including those involved in clozapine’s efficacy and safety, these findings underscore the need for further studies integrating pharmacoepigenetic and pharmacogenetic biomarkers. Our preliminary findings suggest that specific miRNAs could be candidate biomarkers associated with clozapine response in TRS, although these results require validation in larger and controlled studies.

BACKGROUND: Approximately two thirds of all implantation failures are due to impaired endometrial receptivity. The lack of implantation may be due to an implantation window failure found in approximately 25-30% of women with a history of failure to perform assisted reproductive technology protocols. The receptivity phase in such patients can be shifted in terms of timing, have a short duration, or not form. Currently, there are several commercial tests for determining endometrial receptivity based on transcriptomic data. However, these tests differ very significantly from each other in the set of genes studied, and the exact mechanism of endometrial receptivity is still not fully understood. AIM: The aim of this study was to create and check our own test based on RNA AmpliSeq technology to assess the receptivity status of the endometrium and the implantation window. MATERIALS AND METHODS: We previously created an RNAampliSeq panel containing 421 gens. With its use, the differential expression of these genes was analyzed in 38 endometrial samples taken in the proliferative and receptive phases. RESULTS: The studied samples form clearly distinguishable clusters with the receptive and proliferative endometria. 271 genes from our panel are differentially expressed in different phases of the menstrual cycle. CONCLUSIONS: We have created and tested a model that allows clearly distinguishing between the proliferative endometrium and the receptive one and identifying patients with disorders of the menstrual cycle.