title: Effects of sildenafil citrate and etanercept treatment on TNF-α levels in peripheral blood of women with recurrent miscarriage.
abstract: OBJECTIVE
  The aim of the study was to determine serum concentrations of a proinflammatory cytokine, tumor necrosis factor-alpha (TNF-α), in patients with recurrent abortions undergoing treatment with sildenafil or etanercept.
  
  
  METHODS
  Serum TNF-α concentrations were determined for 24 patients with recurrent miscarriages (aged 32.7 ± 4.64 years) deemed eligible for sildenafil therapy and 7 patients treated with etanercept (aged 37.65 ± 5.45 years). Measurements were performed before and after therapy. The control group included 10 healthy women (aged 33.3 ± 5.49 years), who gave birth at least once without pregnancy-related complications. The levels of serum TNF-α were measured by Elisa.
  
  
  RESULTS
  Patients treated with etanercept had significantly elevated levels of TNF-α before therapy as compared to the control group (41.4 ± 28.4 vs. 16.6 ± 7.2 pg/ml). Moreover we found a tendency for the concentration of TNF-α to increase in sera of patients treated with sildenafil after therapy completion (19 ± 29 vs. 15.4 ± 26.7 pg/ml). Treatment with etanercept resulted in a significant reduction of serum TNF-α levels (41.4 ± 28.4 vs. 25.4 ± 3.2 pg/ml).
  
  
  CONCLUSIONS
  Therapy of recurrent abortions with anti-TNF-α drugs appears to be encouraging. Administration of blockers of phosphodiesterase type 5 or TNF-α blockers before conception seems to be a promising future therapy of immune-dependent recurrent miscarriages, limiting the teratogenic influence of the drugs on the fetus.
authors.forename: Monika
authors.initials: M
authors.lastname: Ohams
authors.forename: Małgorzata
authors.initials: M
authors.lastname: Jerzak
authors.forename: Andrzej
authors.initials: A
authors.lastname: Górski
mesh_terms: D000026:Abortion, Habitual / Q000097:blood / Q000517:prevention & control*; D000328:Adult; D004797:Enzyme-Linked Immunosorbent Assay; D000068800:Etanercept; D005260:Female; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D058986:Phosphodiesterase 5 Inhibitors / Q000008:administration & dosage*; D010879:Piperazines / Q000008:administration & dosage*; D011247:Pregnancy; D011687:Purines / Q000008:administration & dosage; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D000068677:Sildenafil Citrate; D013449:Sulfonamides / Q000008:administration & dosage*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors* / Q000097:blood* / Q000187:drug effects
chemical_list: D007074:Immunoglobulin G; D058986:Phosphodiesterase 5 Inhibitors; D010879:Piperazines; D011687:Purines; D018124:Receptors, Tumor Necrosis Factor; D013449:Sulfonamides; D014409:Tumor Necrosis Factor-alpha; D000068677:Sildenafil Citrate; D000068800:Etanercept