title: Endogenous adenosine down-modulates mid-trimester intraamniotic tumor necrosis factor-alpha production.
abstract: OBJECTIVE
  To determine whether adenosine in amniotic fluid down-regulates pro-inflammatory cytokine production.
  
  
  METHODS
  Mid-trimester amniotic fluid from 21 women was incubated ex vivo in the presence or absence of human adenosine deaminase, the enzyme that irreversibly degrades adenosine. After 24 hr, supernatants were assayed by ELISA for tumor necrosis factor-alpha (TNF-alpha), interleukin (IL)-6, and IL-10. Clinical parameters were obtained after completion of laboratory testing.
  
  
  RESULTS
  Inclusion of adenosine deaminase resulted in a median increase in TNF-alpha production from 0.9 to 7.3 pg/mL (P = 0.0014). IL-6 production exhibited a non-significant median increase from <2.0 to 53.0 pg/mL (P = 0.0780). Median IL-10 production increased slightly from a median of <0.2 to 1.3 pg/mL. Adenosine deaminase-stimulated TNF-alpha production was proportional to parity and unrelated to gestational age, time of delivery, maternal age or indication for amniocentesis.
  
  
  CONCLUSIONS
  Adenosine deaminase treatment increases TNF-alpha production by ex vivo-cultured amniotic fluid. Adenosine contributes to immune modulation in the amniotic cavity.
authors.affiliation: Department of Obstetrics and Gynecology, New York Hospital Medical Center of Queens, New York, NY, USA.
authors.forename: Uma
authors.initials: U
authors.lastname: Perni
authors.forename: Devrim
authors.initials: D
authors.lastname: Sezen
authors.forename: Ann Marie
authors.initials: AM
authors.lastname: Bongiovanni
authors.forename: Iara M
authors.initials: IM
authors.lastname: Linhares
authors.forename: Daniel
authors.initials: D
authors.lastname: Skupski
authors.forename: Steven S
authors.initials: SS
authors.lastname: Witkin
mesh_terms: D000659:AMP Deaminase / Q000378:metabolism; D000241:Adenosine / Q000276:immunology* / Q000378:metabolism; D000328:Adult; D000649:Amniocentesis; D000653:Amniotic Fluid / Q000276:immunology / Q000378:metabolism*; D015536:Down-Regulation; D005260:Female; D005786:Gene Expression Regulation; D005865:Gestational Age; D006801:Humans; D016753:Interleukin-10 / Q000378:metabolism; D015850:Interleukin-6 / Q000378:metabolism; D008423:Maternal Age; D011247:Pregnancy; D011262:Pregnancy Trimester, Second / Q000378:metabolism; D014409:Tumor Necrosis Factor-alpha / Q000235:genetics / Q000276:immunology / Q000378:metabolism*
chemical_list: D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D000659:AMP Deaminase; D000241:Adenosine