Hyperresistinemia - a novel feature in systemic infection during human pregnancy.
OBJECTIVE
Resistin, originally described as an adipokine, has emerged as a potent pro-inflammatory protein associated with both acute and chronic inflammation. Moreover, resistin has been proposed as a powerful marker of sepsis severity, as well as a predictor of survival of critically ill non-pregnant patients. The aim of this study was to determine whether pyelonephritis during pregnancy is associated with changes in maternal plasma resistin concentrations.


METHODS
This cross-sectional study included the following groups: (i) normal pregnant women (n = 85) and (ii) pregnant women with pyelonephritis (n = 40). Maternal plasma resistin concentrations were determined by ELISA. Non-parametric statistics was used for analyses.


RESULTS
(i) The median maternal plasma resistin concentration was higher in patients with pyelonephritis than in those with a normal pregnancy (P < 0.001); (ii) among patients with pyelonephritis, the median maternal resistin concentration did not differ significantly between those with and without a positive blood culture (P = 0.3); (iii) among patients with pyelonephritis who were diagnosed with systemic inflammatory response syndrome (SIRS), those who fulfilled > or =3 criteria for SIRS had a significantly higher median maternal plasma resistin concentration than those who met only two criteria; and (iv) maternal WBC count positively correlated with circulating resistin concentration (r = 0.47, P = 0.02).


CONCLUSIONS
Hyperresistinemia is a feature of acute pyelonephritis during pregnancy. The results of this study support the role of resistin as an acute-phase protein in the presence of bacterial infection during pregnancy.
Mazaki-Tovi
Shali
S
Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Bethesda, MD, USA.
Vaisbuch
Edi
E
Romero
Roberto
R
Kusanovic
Juan Pedro
JP
Chaiworapongsa
Tinnakorn
T
Kim
Sun Kwon
SK
Ogge
Giovanna
G
Yoon
Bo Hyun
BH
Dong
Zhong
Z
Gonzalez
Juan M
JM
Gervasi
Maria Teresa
MT
Hassan
Sonia S
SS
D000328:Adult; D005260:Female; D006801:Humans; D011247:Pregnancy; D011251:Pregnancy Complications, Infectious / Q000276:immunology* / Q000382:microbiology; D011704:Pyelonephritis / Q000150:complications / Q000276:immunology* / Q000382:microbiology; D055815:Young Adult