Expression of cytokines and chemokines in cervical and amniotic fluid: relationship to histological chorioamnionitis.
OBJECTIVE
To correlate cervical and amniotic fluid cytokines and macrophage-related chemokines to the development of histological chorioamnionitis (HCA) in patients with preterm labor (PTL) and preterm prelabor rupture of the membranes (PPROM).


METHODS
Cervical and amniotic fluid interleukin (IL)-6, IL-8, IL-18, monocyte chemotactic protein (MCP)-1, MCP-2, and MCP-3 from pregnant women (at <or=34 weeks of gestation) in PTL (N = 42) were analyzed and related to the subsequent occurrence of HCA or inflammatory signs in the placenta. For the patients with PPROM (N = 30) only amniotic fluid proteins were analyzed.


RESULTS
Intra-amniotic levels of IL-6, IL-8, IL-18, MCP-1, and MCP-3 were significantly higher in PTL cases with HCA compared to non-HCA controls, whereas no such relationship was obtained in the PPROM group. Cervical IL-8 and IL-6 (but not IL-18, MCP-1, MCP-2, and MCP-3) in PTL patients was associated with HCA, and at a cut-off level of 10.0 ng/mL cervical IL-8 was a strong predictor of HCA in the PTL cases (sensitivity 100%, specificity 67%, positive predictive value 63%, negative predictive value 100%). The cytokine and chemokine levels in the group with inflammatory signs were generally higher than in controls but lower compared to the concentrations in the HCA group.


CONCLUSIONS
The amniotic levels of IL-6, IL-8, IL-18, and the CC-chemokines MCP-1 and MCP-3 in PTL patients all predicted HCA, whereas only IL-8 was a clinically useful marker of HCA in the cervical fluid. In addition there is indication that the levels of inflammatory proteins are related to the degree of inflammatory infiltration in placental tissue samples.
Department of Obstetrics and Gynecology, Perinatal Center, Institute for Clinical Sciences, Sahlgrenska Academy, East Hospital, Göteborg, Sweden. rose-marie.holst@vgregion.se
Rose-Marie
RM
Holst
Ricardo
R
Laurini
Bo
B
Jacobsson
Ellen
E
Samuelsson
Karin
K
Sävman
Christina
C
Doverhag
Ulla-Britt
UB
Wennerholm
Henrik
H
Hagberg
D000328:Adult; D000653:Amniotic Fluid / Q000276:immunology*; D015415:Biomarkers; D016022:Case-Control Studies; D002584:Cervix Uteri / Q000276:immunology*; D018932:Chemokine CCL2 / Q000378:metabolism; D018925:Chemokines / Q000378:metabolism*; D002821:Chorioamnionitis / Q000276:immunology*; D016207:Cytokines / Q000378:metabolism*; D005260:Female; D005322:Premature Rupture of Fetal Membranes / Q000276:immunology; D006801:Humans; D007378:Interleukins / Q000378:metabolism; D007752:Obstetric Labor, Premature / Q000276:immunology; D010920:Placenta / Q000276:immunology; D011247:Pregnancy; D011446:Prospective Studies
D015415:Biomarkers; D018932:Chemokine CCL2; D018925:Chemokines; D016207:Cytokines; D007378:Interleukins