Amniotic fluid cytokine profile in association with fetal hyperechogenic bowel.
OBJECTIVE
Fetal hyperechogenic bowel (FEB) is associated with infection, chromosomal abnormalities and poor fetal outcome. FEB may result from an intrauterine fetal bowel cytokine-mediated inflammatory response. Since alterations in the levels of the cytokines interleukin (IL)-6, IL-8, IL-10, tumour necrosis factor (TNF)-alpha and interferon (IFN)-gamma are associated with pregnancy complications and necrotizing enterocolitis, this study aimed: (i) to determine their involvement in the pathophysiology of FEB and (ii) to identify their role as amniotic fluid markers of this condition.


METHODS
In this prospective case-control study, amniotic fluid was collected by transabdominal amniocentesis from pregnant women with fetuses presenting (n=10)--or not (n=30)--with FEB during routine 18-20 week ultrasound scans. Cell-free amniotic fluid samples were analysed for cytokine concentrations by fluid-phase multiplex immunoassay. Data were compared by Mann-Whitney U-tests and Pearson correlations.


RESULTS
Amniotic fluid IL-8 levels were significantly higher in the FEB group. There was a positive correlation between IL-6 and each of IL-8 and INF-gamma, as well as between IL-8 and IL-10, and TNF-alpha and INF-gamma.


CONCLUSIONS
FEB likely ensues from a fetal inflammatory process involving IL-8 and, possibly, IL-6 and IL-10. This indicates the potential of immunomodulatory therapy in the management of FEB.
Department of Obstetrics & Gynaecology, Gledhow Wing, St James's University Hospital, Beckett Street, LS9 7TF, Leeds, UK.
Alex E
AE
Oboh
Nicolas M
NM
Orsi
James
J
Campbell
D000328:Adult; D000653:Amniotic Fluid / Q000737:chemistry*; D015415:Biomarkers; D016022:Case-Control Studies; D016207:Cytokines / Q000032:analysis*; D005260:Female; D005315:Fetal Diseases / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D006801:Humans; D007410:Intestinal Diseases / Q000000981:diagnostic imaging / Q000276:immunology / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis*; D011256:Pregnancy Outcome; D011296:Prenatal Diagnosis; D011446:Prospective Studies; D014463:Ultrasonography
D015415:Biomarkers; D016207:Cytokines