Differential expression of immune system-related components in midtrimester amniotic fluid from singleton and twin pregnancies.
OBJECTIVE
We investigated differences between singleton and twin gestations in immune mediators in midtrimester amniotic fluid.


METHODS
Amniotic fluid from 252 singleton and 46 twin gestations were tested by enzyme-linked immunosorbent assay for interleukin-1beta, interleukin-1 receptor antagonist, interleukin-4, tumor necrosis factor-alpha, nitric oxide, Clara cell protein 16, leptin, and the 70-kDa heat shock protein. A subset of amniotic fluid was also tested for leukemia inhibitory factor, angiogenin, and migration inhibitory factor-related protein 8 and migration inhibitory factor-related protein 14. Data were analyzed by the Mann-Whitney U test and Spearman rank correlation.


RESULTS
Median concentrations of interleukin-1beta, tumor necrosis factor-alpha, interleukin-4, Clara cell protein 16, leptin, and angiogenin were increased in amniotic fluid from twins; median levels of the 70-kDa heat shock protein, leukemia inhibitory factor, migration inhibitory factor-related protein 8, and migration inhibitory factor-related protein 14 were highest in amniotic fluid from singletons (P < .001).


CONCLUSIONS
Elevated levels of immune activators may contribute to the increased rate of preterm premature rupture of membranes and spontaneous preterm birth in twin populations.
Perni
Sriram C
SC
Division of Maternal-Fetal Medicine, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY 10021, USA. scperni@yahoo.com
Kalish
Robin B
RB
Hutson
J Milton
JM
Karasahin
Emre
E
Bongiovanni
Ann Marie
AM
Ratushny
Vladimir
V
Chasen
Stephen T
ST
Witkin
Steven S
SS
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry* / Q000276:immunology; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000276:immunology; D018840:HSP70 Heat-Shock Proteins / Q000032:analysis; D006801:Humans; D007249:Inflammation / Q000276:immunology; D007375:Interleukin-1 / Q000032:analysis; D007378:Interleukins / Q000032:analysis*; D020738:Leptin / Q000032:analysis; D008263:Macrophage Migration-Inhibitory Factors / Q000032:analysis; D010741:Phospholipases A / Q000037:antagonists & inhibitors; D011247:Pregnancy / Q000276:immunology*; D011262:Pregnancy Trimester, Second; D011272:Pregnancy, Multiple / Q000276:immunology*; D014427:Twins; D014598:Uteroglobin / Q000276:immunology
D018840:HSP70 Heat-Shock Proteins; D007375:Interleukin-1; D007378:Interleukins; D020738:Leptin; D008263:Macrophage Migration-Inhibitory Factors; C556389:SCGB1A1 protein, human; D014598:Uteroglobin; D010741:Phospholipases A