Association of umbilical placental vascular disease with fetal acute inflammatory cytokine responses.
OBJECTIVE
We examined the hypothesis that fetal proinflammatory cytokine release is a feature of placental vascular disease causing fetal compromise. We measured the concentrations of fetal proinflammatory cytokines interleukin 6 (IL-6), tumor necrosis factor alpha (TNF-alpha), and interleukin-8 (IL-8) in the presence of vascular disease in the umbilical placental villous circulation. Vascular disease was identified by high-resistance umbilical artery Doppler flow velocity waveform studies.


METHODS
We measured levels of the inflammatory cytokines IL-6 and TNF-alpha and the chemokine IL-8 in fetal blood. Blood was collected from the umbilical vein at delivery, and serum was stored at -70C until assayed using chemiluminescent and enzyme-linked immunosorbent assay methods. We studied 36 normal pregnancies delivered by elective cesarean at term and 50 pregnancies with a high-resistance umbilical artery Doppler flow velocity waveform pattern indicative of fetal placental vascular disease delivered by elective cesarean because of potential fetal compromise.


RESULTS
In the presence of umbilical placental vascular disease there were significantly higher levels of IL-6 (median 5.3 pg/mL, P <.05) and IL-8 (median 26.5 pg/mL, P <.01) compared with normal pregnancies (median value of IL-6 and IL-8 were below assay threshold). There was no difference for TNF-alpha, with the median results undetectable in both groups.


CONCLUSIONS
We found higher concentrations of IL-6 and IL-8 in the fetal circulation in the presence of umbilical placental vascular disease.
Trudinger
Brian
B
Department of Obstetrics and Gynaecology, University of Sydney at Westmead Hospital, PO Box 533, Wentworthville, New South Wales 2145, Australia. briant@westgate.wh.usyd.edu.au
Wang
Jun
J
Athayde
Neil
N
Beutler
Lucinda
L
Wang
Xin
X
D000328:Adult; D001724:Birth Weight; D016207:Cytokines / Q000097:blood / Q000378:metabolism*; D036861:Delivery, Obstetric; D005260:Female; D005312:Fetal Blood / Q000737:chemistry / Q000276:immunology; D005315:Fetal Diseases / Q000503:physiopathology*; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007249:Inflammation / Q000503:physiopathology*; D015850:Interleukin-6 / Q000097:blood; D008423:Maternal Age; D010920:Placenta / Q000098:blood supply*; D010927:Placental Insufficiency / Q000503:physiopathology*; D011247:Pregnancy; D012016:Reference Values; D014409:Tumor Necrosis Factor-alpha / Q000032:analysis; D014652:Vascular Diseases / Q000503:physiopathology*
D016207:Cytokines; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha