title: Interleukin-19 in fetal systemic inflammation.
abstract: OBJECTIVE
  The fetal inflammatory response syndrome (FIRS) is considered the fetal counterpart of the systemic inflammatory response syndrome (SIRS), which can be caused by infection and non-infection-related insults. Although the initial response is mediated by pro-inflammatory signals, the control of this response is achieved by anti-inflammatory mediators which are essential for the successful outcome of the affected individual. Interleukin (IL)-19 is capable of stimulating the production of IL-10, a major anti-inflammatory cytokine, and is a potent inducer of the T-helper 2 (Th2) response. The aim of this study was to determine if there is a change in umbilical cord plasma IL-19 and IL-10 concentrations in preterm neonates with and without acute funisitis, the histologic counterpart of FIRS.
  
  
  METHODS
  A case-control study was conducted including 80 preterm neonates born after spontaneous labor. Neonates were classified according to the presence (n = 40) or absence of funisitis (n = 40), which is the pathologic hallmark of FIRS. Neonates in each group were also matched for gestational age. Umbilical cord plasma IL-19 and IL-10 concentrations were determined by ELISA.
  
  
  RESULTS
  1) The median umbilical cord plasma IL-19 concentration was 2.5-fold higher in neonates with funisitis than in those without funisitis (median 87 pg/mL; range 20.6-412.6 pg/mL vs. median 37 pg/mL; range 0-101.7 pg/mL; p < 0.001); 2) newborns with funisitis had a significantly higher median umbilical cord plasma IL-10 concentration than those without funisitis (median 4 pg/mL; range 0-33.5 pg/mL vs. median 2 pg/mL; range 0-13.8 pg/mL; p < 0.001); and 3) the results were similar when we included only patients with funisitis who met the definition of FIRS by umbilical cord plasma IL-6 concentrations ≥ 17.5 pg/mL (p < 0.001).
  
  
  CONCLUSIONS
  IL-19 and IL-10 are parts of the immunologic response of FIRS. A subset of fetuses with FIRS had high umbilical cord plasma IL-19 concentrations. In utero exposure to high systemic concentrations of IL-19 may reprogram the immune response.
authors.affiliation: Perinatology Research Branch, NICHD/NIH/DHHS, Detroit, Michigan 48201, USA.
authors.forename: Zeynep Alpay
authors.initials: ZA
authors.lastname: Savasan
authors.forename: Tinnakorn
authors.initials: T
authors.lastname: Chaiworapongsa
authors.forename: Roberto
authors.initials: R
authors.lastname: Romero
authors.forename: Youssef
authors.initials: Y
authors.lastname: Hussein
authors.forename: Juan Pedro
authors.initials: JP
authors.lastname: Kusanovic
authors.forename: Yi
authors.initials: Y
authors.lastname: Xu
authors.forename: Zhong
authors.initials: Z
authors.lastname: Dong
authors.forename: Chong Jai
authors.initials: CJ
authors.lastname: Kim
authors.forename: Sonia S
authors.initials: SS
authors.lastname: Hassan
mesh_terms: D000293:Adolescent; D000328:Adult; D016022:Case-Control Studies; D002821:Chorioamnionitis / Q000097:blood*; D005260:Female; D005312:Fetal Blood / Q000378:metabolism; D006801:Humans; D007231:Infant, Newborn; D016753:Interleukin-10 / Q000097:blood*; D007378:Interleukins / Q000097:blood*; D011247:Pregnancy; D018746:Systemic Inflammatory Response Syndrome / Q000097:blood*; D055815:Young Adult
chemical_list: C508609:IL10 protein, human; C421250:IL19 protein, human; D007378:Interleukins; D016753:Interleukin-10