Circulating cytokines, chemokines and adhesion molecules in normal pregnancy and preeclampsia determined by multiplex suspension array

Abstract

BackgroundPreeclampsia is a severe complication of pregnancy characterized by an excessive maternal systemic inflammatory response with activation of both the innate and adaptive arms of the immune system. Cytokines, chemokines and adhesion molecules are central to innate and adaptive immune processes. The purpose of this study was to determine circulating levels of cytokines, chemokines and adhesion molecules in normal pregnancy and preeclampsia in a comprehensive manner, and to investigate their relationship to the clinical features and laboratory parameters of the study participants, including markers of overall inflammation (C-reactive protein), endothelial activation (von Willebrand factor antigen) and endothelial injury (fibronectin), oxidative stress (malondialdehyde) and trophoblast debris (cell-free fetal DNA).ResultsSerum levels of interleukin (IL)-1beta, IL-1 receptor antagonist (IL-1ra), IL-2, IL-4, IL-6, IL-8, IL-10, IL-12p40, IL-12p70, IL-18, interferon (IFN)-gamma, tumor necrosis factor (TNF)-alpha, transforming growth factor (TGF)-beta1, interferon-gamma-inducible protein (IP)-10, monocyte chemotactic protein (MCP)-1, intercellular adhesion molecule (ICAM)-1 and vascular cell adhesion molecule (VCAM)-1 were measured in 60 preeclamptic patients, 60 healthy pregnant women and 59 healthy non-pregnant women by multiplex suspension array and ELISA. In normal pregnancy, the relative abundance of circulating IL-18 over IL-12p70 and the relative deficiency of the bioactive IL-12p70 in relation to IL-12p40 might favour Th2-type immunity. Although decreased IL-1ra, TNF-alpha and MCP-1 concentrations of healthy pregnant relative to non-pregnant women reflect anti-inflammatory changes in circulating cytokine profile, their decreased serum IL-10 and increased IP-10 levels might drive pro-inflammatory responses. In addition to a shift towards Th1-type immunity (expressed by the increased IL-2/IL-4 and IFN-gamma/IL-4 ratios), circulating levels of the pro-inflammatory cytokines IL-6 and TNF-alpha, the chemokines IL-8, IP-10 and MCP-1, as well as the adhesion molecules ICAM-1 and VCAM-1, were raised in preeclampsia compared with healthy pregnancy, resulting in an overall pro-inflammatory systemic environment. Increased IP-10, MCP-1, ICAM-1 and VCAM-1 concentrations of preeclamptic patients showed significant correlations with blood pressure values, renal and liver function parameters, as well as with CRP, malondialdehyde, von Willebrand factor antigen and fibronectin levels.ConclusionsAccording to our findings, preeclampsia was associated with an overall pro-inflammatory systemic environment. Elevated amounts of pro-inflammatory cytokines, chemokines and adhesion molecules in the maternal circulation might play a central role in the excessive systemic inflammatory response, as well as in the generalized endothelial dysfunction characteristics of the maternal syndrome of preeclampsia.

The integrative roles of chemokines at the maternal–fetal interface in early pregnancy

“…52,57 Serum levels of CXCL10 and CXCL8 are also elevated during pre-eclampsia compared with healthy pregnancies, resulting in an overall pro-inflammatory systemic environment. 118,119 Increased CXCL10 and CCL2 concentrations in pre-eclamptic patients significantly correlate with blood pressure values, and renal and liver function parameters. 52 These chemokines and their underlying signaling molecules are potential diagnostic and therapeutic targets for pre-eclampsia management.…”

The obstetric syndromes: clinical relevance of placental hormones

“…More elevated serum concentrations of heat-shock protein 70, considered a potent activator of the classical pathway of the human complement system, are present in PE patients and its elevated levels are associated with proinflammatory changes in circulating cytokine profile, suggesting that it may contribute to the development of the excessive systemic inflammatory response characteristic of the maternal syndrome of the disease [57]. Another evidence of the activation of the immune system is demonstrated by the inflammatory environment which characterized PE: an increase of proinflammatory cytokines, such as IL-6 and TNF-α, of chemokines, as IL-8, IP-10 and MCP-10, and of adhesion molecules, such as ICAM-1 and VCAM-1, has been highlighted in PE, suggesting the potential role of these molecules in endothelial dysfunction [58]. More relevant data with regard to prevention of this important disease are those relating to markers of pathology, already present midtrimester, such as factor B-derived Bb activation fragment from the alternative complement pathway, which may be used as a marker of the complement activation.…”

Syzygium Cumini Reduces Vcam-1 and Icam-1 Expression in Endothelial Cells Induced by Plasma from Preeclamptic Patients

“…When the stimulus presence, this molecule will upregulated [4]. In preeclampsia, this adhesion molecules levels showed significant correlations with blood pressure values, renal and liver function markers [5]. In order to inhibits this dysfunction, a new approach by herbal treatment may promise.…”