title: Maternal serum soluble CD30 is increased in pregnancies complicated with acute pyelonephritis.
abstract: OBJECTIVE
  Normal pregnancy is characterized by activation of the innate immunity and suppression of the adaptive limb of the immune response. However, pregnant women are more susceptible to the effects of infection and microbial products than non-pregnant women. CD30 is a member of the tumor necrosis factor receptor superfamily and is preferentially expressed by activated T cells producing Th2-type cytokines. Its soluble form (sCD30) is proposed to be an index of Th2 immune response. High serum concentrations of sCD30 have been found in the acute phase of viral infections, such as HIV-1 and hepatitis B. There is, however, conflicting evidence about serum sCD30 concentration in patients with bacterial infections. The objective of this study was to determine whether there are changes in the serum concentration of sCD30 in pregnant women with pyelonephritis.
  
  
  METHODS
  This cross-sectional study included normal pregnant women (N = 89) and pregnant women with pyelonephritis (N = 41). Maternal serum concentration of sCD30 was measured by a specific and sensitive enzyme-linked immunoassay. Non-parametric tests were used for comparisons. A p value <0.05 was considered statistically significant.
  
  
  RESULTS
  (1) Pregnant women with pyelonephritis had a significantly higher median serum concentration of sCD30 than those with a normal pregnancy (median 44.3 U/mL, range 16-352.5 vs. median 29.7 U/mL, range 12.2-313.2, respectively; p < 0.001), and (2) No significant differences were found in the median maternal serum concentration of sCD30 between pregnant women with pyelonephritis who had a positive blood culture compared to those with a negative blood culture (median 47.7 U/mL, range 17.1-118.8 vs. median 42.6 U/mL, range 16-352.5, respectively; p = 0.86).
  
  
  CONCLUSIONS
  Acute pyelonephritis during pregnancy is associated with a higher maternal serum concentration of sCD30 than normal pregnancy. This finding is novel and suggests that pregnant women with pyelonephritis may have a complex immune state in which there is activation of some components of what is considered a Th2 immune response.
authors.affiliation: Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA.
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Jimmy
authors.initials: J
authors.lastname: Esoinoza
authors.forename: Francesca
authors.initials: F
authors.lastname: Gotsch
authors.forename: Samuel
authors.initials: S
authors.lastname: Edwin
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.forename: Pooja
authors.initials: P
authors.lastname: Mittal
authors.forename: Eleazar
authors.initials: E
authors.lastname: Soto
authors.forename: Offer
authors.initials: O
authors.lastname: Erez
authors.forename: Shali
authors.initials: S
authors.lastname: Mazaki-Tovi
authors.forename: Nandor Gabor
authors.initials: NG
authors.lastname: Than
authors.forename: Lara A
authors.initials: LA
authors.lastname: Friel
authors.forename: Bo Hyun
authors.initials: BH
authors.lastname: Yoon
authors.forename: Moshe
authors.initials: M
authors.lastname: Mazor
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
mesh_terms: D000293:Adolescent; D000328:Adult; D016470:Bacteremia / Q000276:immunology; D016022:Case-Control Studies; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D017730:Ki-1 Antigen / Q000097:blood*; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000097:blood*; D011704:Pyelonephritis / Q000097:blood* / Q000150:complications*
chemical_list: D017730:Ki-1 Antigen