title: Anticytokine therapy in preterm labor: current knowledge and future perspectives.
abstract: OBJECTIVE
  Up to 10% of pregnant women have preterm birth that might be refractory to current therapy. Infections and asphyxia related to preterm birth are the causes of death in the majority of neonates and therefore represent an urgent clinical need.
  
  
  METHODS
  The present article reviews the English language literature for preclinical and clinical trials and promising molecular targets on preterm labor.
  
  
  RESULTS
  Preterm birth is a complex heterogeneous condition. There is no current treatment for the fetal membranes once they have ruptured; therefore, essentially any treatment has to be preventative to quiesce preterm labor and prevent any spread of infection to the fetus. Modulating the pro-inflammatory process-mediated cytokine network may present a new paradigm for preterm labor treatment. There are many reports on the role of β-adrenergic agonists (betamimetics), magnesium sulfate, progesterone, oxytocin antagonist, calcium channel blocker or the Kunitz inhibitor bikunin in the treatment of preterm labor. In the present review, we have focused on the preclinical and clinical anticytokine therapy for preterm labor. The preclinical and clinical trials with bikunin reducing preterm labor exacerbations have raised the importance of usefulness and safety considerations related to this novel therapy.
  
  
  CONCLUSIONS
  Anticytokine therapy is ready for the clinic.
authors.affiliation: Department of Obstetrics and Gynecology, Nara Medical University, Nara, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Sado
authors.forename: Takashi
authors.initials: T
authors.lastname: Kitanaka
authors.forename: Katsuhiko
authors.initials: K
authors.lastname: Naruse
authors.forename: Hidekazu
authors.initials: H
authors.lastname: Oi
authors.forename: Taketoshi
authors.initials: T
authors.lastname: Noguchi
authors.forename: Shozo
authors.initials: S
authors.lastname: Yoshida
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kajihara
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Shigetomi
authors.forename: Akira
authors.initials: A
authors.lastname: Oonogi
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Kobayashi
mesh_terms: D000818:Animals; D016207:Cytokines / Q000037:antagonists & inhibitors*; D005260:Female; D006801:Humans; D007752:Obstetric Labor, Premature / Q000188:drug therapy* / Q000276:immunology* / Q000503:physiopathology; D011247:Pregnancy
chemical_list: D016207:Cytokines