A correlation of pregnancy term, disease activity, serum female hormones, and cytokines in uveitis.
OBJECTIVE
Pregnancy and the postpartum period are associated with the activity of autoimmune diseases including uveitis. Although the exact mechanism is unknown, hormones are reported to alter inflammatory cytokines and influence disease activity. The authors studied ocular inflammation, female hormones, and serum cytokine levels during and after pregnancy.


METHODS
A prospective, observational case study was conducted. Four pregnant women in their first trimester with chronic non-infectious uveitis were followed monthly until 6 months after delivery. Serum female hormones (oestrogen, progesterone, prolactin) and various cytokines (IL-2, IL-4, IL-5, IL-6, IL-10, IFN-gamma, and TGF-beta) were measured by ELISA.


RESULTS
The four patients had five full term pregnancies. Uveitis activity decreased after the first trimester but flared in the early postpartum period. Serum female hormones, highly elevated during pregnancy, drastically dropped post partum. Cytokine levels except TGF-beta were mostly undetectable.


CONCLUSIONS
Female hormones and TGF-beta may contribute to the activity of uveitis during pregnancy and the postpartum period.
Chan
C-C
CC
National Eye Institute/NIH, Bldg 10, Room 10N103,10 Center Drive, Bethesda, MD 20892-1857, USA. chanc@nei.nih.gov
Reed
G F
GF
Kim
Y
Y
Agrón
E
E
Buggage
R R
RR
D000284:Administration, Oral; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage; D016207:Cytokines / Q000097:blood*; D004967:Estrogens / Q000097:blood; D005260:Female; D006728:Hormones / Q000097:blood*; D006801:Humans; D007378:Interleukins / Q000097:blood; D049590:Postpartum Period; D011241:Prednisone / Q000008:administration & dosage; D011247:Pregnancy; D011248:Pregnancy Complications / Q000097:blood* / Q000188:drug therapy; D011261:Pregnancy Trimester, First; D011374:Progesterone / Q000097:blood; D011388:Prolactin / Q000097:blood; D011446:Prospective Studies; D016212:Transforming Growth Factor beta / Q000097:blood; D014605:Uveitis / Q000097:blood* / Q000188:drug therapy
D000893:Anti-Inflammatory Agents; D016207:Cytokines; D004967:Estrogens; D006728:Hormones; D007378:Interleukins; D016212:Transforming Growth Factor beta; D011374:Progesterone; D011388:Prolactin; D011241:Prednisone