DISTURBED MATERNAL IMMUNE MILIEU EARLY IN PREGNANCY COULD PREDICT LATER DEVELOPMENT OF PRE-ECLAMPSIA AND DIFFERENTIATE ITS SEVERITY GRADES.
Journal Title: International Journal of Advanced Research (IJAR) - Year 2018, Vol 6, Issue 2
Abstract
Objectives: To estimate serum levels of tumor necrosis factor-? (TNF-?), interleukin (IL)-6 and IL-10 in primigravida women at the 12th week of gestation and to evaluate its predictability for later development and severity of pre-eclampsia (PE). Patients & Methods: The study included 130 primigravida women evaluated at the 12th week gestational age clinically to assure being normotensive and gave blood samples for ELISA estimation of serum levels of TNF-?, IL-6 and IL-10. All patients were evaluated 4-weekly for development of PE that was categorized as early or late and mild or severe. Results: Sixty-five women developed PE; 23 early PE and 42 late; 47 mild and 18 severe PE. Serum TNF-? and IL-6 levels were significantly higher, while serum IL-10 levels were significantly lower in PE than control women with significantly higher IL-6/IL-10 ratio in PE women. ROC curve analysis defined high body weight, body mass index, high serum IL-6 and TNF-? and high IL-6/IL-10 ratio as significant specific predictor, while low serum IL-10 as a significant sensitive predictor for possibility of development of PE. Also, ROC curve analysis defined high IL-6/IL-10 ratio as significant sensitive predictor for severe PE, while defined high serum IL-6 and high TNF-? as significant specific predictors for mild PE. Conclusion: Pre-eclampsia was associated with shift of immune response to pregnancy towards production of pro-inflammatory cytokines. The detected early disturbance of immune milieu points to its role in pathogenesis of PE. High IL-6/IL-10 ratio early in pregnancy could predict later development of PE especially severe PE. High IL-6 and TNF-? serum levels could early predict the development of mild PE.
Authors and Affiliations
Amr Sharafeldeen
Keywords
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- EP ID EP278910
- DOI 10.21474/IJAR01/6535
- Views 73
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