title: Role of cytokines in development of pre-eclampsia associated with periodontal disease - Cohort Study.
abstract: OBJECTIVE
  The present study was designed to find any association of cytokines in women with periodontal disease and development of pre-eclampsia in North Indian population.
  
  
  METHODS
  A total of 504 consecutively registered primigravida with a single live pregnancy were recruited at 14-18 weeks of gestation from antenatal clinic of Maulana Azad Medical College & associated Lok Nayak Hospital and Maulana Azad Institute of Dental Sciences, New Delhi. One periodontist performed oral health examination of all patients at inclusion into study. Blood samples were collected to measure the level of cytokines IL-4, IL-10, TNF-α and IFN-γ.
  
  
  RESULTS
  The profile of blood levels of cytokines from women with periodontal disease was observed. The log serum levels of TNF-α & IL-4 at 16-18 weeks of gestation were significantly higher in women with periodontal disease (4.13 ± 2.06; 0.47 ± 1.56 pg/ml respectively) than in women with healthy gums (2.16 ± 1.51; 0.02 ± 1.84 pg/ml respectively, p < 0.001). Periodontal disease is associated with log serum TNF-α levels at cut-off ≥14.43 pg/ml at sensitivity 71.2% and specificity 62% (OR = 4.04; 95%CI = 2.77-5.87). Woman with periodontal disease who later developed pre-eclampsia had lower levels of TNF-α (3.72 ± 1.33 pg/ml) than those with periodontal disease who did not develop pre-eclampsia (4.20 ± 2.15 pg/ml, p ≥ 0.05).
  
  
  CONCLUSIONS
  Reduced TNF-α level secretion in the early second trimester in women with periodontal disease appears to be associated with the development of pre-eclampsia.
authors.affiliation: Department of Obstetrics & Gynecology, Maulana Azad Medical College & Lok Nayak Hospital, New Delhi, India.
authors.forename: Ashok
authors.initials: A
authors.lastname: Kumar
authors.forename: Nargis
authors.initials: N
authors.lastname: Begum
authors.forename: Sudha
authors.initials: S
authors.lastname: Prasad
authors.forename: Arundeep K
authors.initials: AK
authors.lastname: Lamba
authors.forename: Mahesh
authors.initials: M
authors.lastname: Verma
authors.forename: Sarita
authors.initials: S
authors.lastname: Agarwal
authors.forename: Shashi
authors.initials: S
authors.lastname: Sharma
mesh_terms: D000328:Adult; D015331:Cohort Studies; D016207:Cytokines / Q000097:blood*; D005260:Female; D005500:Follow-Up Studies; D005891:Gingivitis / Q000097:blood / Q000276:immunology; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016753:Interleukin-10 / Q000097:blood; D015847:Interleukin-4 / Q000097:blood; D010298:Parity; D017622:Periodontal Attachment Loss / Q000097:blood / Q000276:immunology; D010510:Periodontal Diseases / Q000097:blood / Q000276:immunology*; D010514:Periodontal Pocket / Q000097:blood / Q000276:immunology; D011225:Pre-Eclampsia / Q000097:blood / Q000209:etiology*; D011247:Pregnancy; D011256:Pregnancy Outcome; D011261:Pregnancy Trimester, First / Q000097:blood / Q000276:immunology; D011262:Pregnancy Trimester, Second / Q000097:blood / Q000276:immunology; D012680:Sensitivity and Specificity; D012923:Social Class; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
chemical_list: D016207:Cytokines; C508609:IL10 protein, human; C508598:IL4 protein, human; D014409:Tumor Necrosis Factor-alpha; D016753:Interleukin-10; D015847:Interleukin-4; D007371:Interferon-gamma
keywords: TNF-α; cytokines; periodontal disease; pre-eclampsia; primigravidae