Proinflammatory macrophage migratory inhibition factor and interleukin-6 are concentrated in pleural effusion of human fetuses with prenatal chylothorax.
OBJECTIVE
To study the role of selected cytokines and growth factors involved in the pathogenesis of fetal chylous pleural effusion.


METHODS
Seventeen fetuses with prenatal chylothorax at gestational age (GA) 17-29 weeks were enrolled as the study group during the period 2003-2005. Their pleural effusion (n = 17) and amniotic fluid (n = 17) were drawn when disease set in. Eleven fetuses received cordocentesis because of suspected fetal anemia. Forty-one normal fetuses without adverse perinatal outcome at GA 17-29 weeks received amniocentesis and were enrolled in the reference group. Levels of hepatocyte growth factor (HGF), stromal-derived factor-1(SDF-1), vascular endothelial growth factor (VEGF), interleukin-8 (IL-8), macrophage migratory inhibition factor (MIF), and interleukin-6 (IL-6) were determined in the samples from both groups (amniotic fluid, pleural fluid, and cord blood from the study group and amniotic fluid from the reference group) by enzyme-linked immunoassay (EIA).


RESULTS
No significant differences were observed in the amniotic fluids between the study group and the reference group regarding levels of IL-6, IL-8, MIF, SDF-1, HGF and VEGF. In the study group, levels of IL-8, VEGF and SDF-1 (all pro-angiogenic) showed no significant differences between the amniotic fluid, cord blood and pleural effusion. The level of HGF (proangiogenic) was significantly higher in the amniotic fluid than in the cord blood or the pleural effusion, but there were no significant differences between the levels in the pleural fluid and in the cord blood. Interestingly, the levels of MIF and IL-6 (both are proinflammatory) in the amniotic fluid and in the pleural effusion were much higher than the levels in the cord blood.


CONCLUSIONS
Our study demonstrated that the levels of pro-inflammatory proteins (MIF and IL-6) that we tested were higher in the fetal pleural effusion than in the fetal circulation, a phenomenon not observed in the levels of proangiogenic proteins (HGF, SDF-1, VEGF, IL-8). This result implies that inflammation-related proteins may be more relevant than the angiogenesis-related proteins in the local environment of accumulating pleural effusion, a prominent feature of prenatal chylothorax.
Chen
Ming
M
Department of Obstetrics and Gynecology, Changhua Christian Hospital, Changhua, Taiwan.
Hsieh
Chang-Yao
CY
Shih
Jin-Chung
JC
Chou
Chia-Hung
CH
Ma
Gwo-Chin
GC
Chen
Tze-Ho
TH
Lee
Tsung-Hsien
TH
Tsai
Horng-Der
HD
Cameron
Alan D
AD
Chen
Chih-Ping
CP
D000653:Amniotic Fluid / Q000276:immunology; D016022:Case-Control Studies; D054377:Chemokine CXCL12; D019743:Chemokines, CXC / Q000276:immunology; D002916:Chylothorax / Q000196:embryology / Q000276:immunology*; D005260:Female; D005312:Fetal Blood / Q000276:immunology; D017228:Hepatocyte Growth Factor / Q000276:immunology; D006801:Humans; D015850:Interleukin-6 / Q000276:immunology; D016209:Interleukin-8 / Q000276:immunology; D008263:Macrophage Migration-Inhibitory Factors / Q000276:immunology; D008297:Male; D010996:Pleural Effusion / Q000196:embryology / Q000276:immunology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011262:Pregnancy Trimester, Second; D042461:Vascular Endothelial Growth Factor A / Q000276:immunology
C515255:CXCL12 protein, human; D054377:Chemokine CXCL12; D019743:Chemokines, CXC; D015850:Interleukin-6; D016209:Interleukin-8; D008263:Macrophage Migration-Inhibitory Factors; D042461:Vascular Endothelial Growth Factor A; D017228:Hepatocyte Growth Factor