The association between amniotic fluid-derived inflammatory mediators and the risk of retinopathy of prematurity

Abstract

Prenatal and perinatal infections and inflammation appear to associated with the development of retinopathy of prematurity (ROP). In this study, we evaluated whether inflammatory mediators in amniotic fluid (AF) retrieved during cesarean delivery influence the development of ROP in very low birth weight (VLBW) infants. This retrospective study included 16 and 32 VLBW infants who did and did not develop any stage of ROP, respectively. Each infant with ROP was matched with 2 infants without ROP based on days of ventilation care, gestational age, and birth weight. AF was obtained during cesarean delivery, and the levels of intra-amniotic inflammatory mediators such as interleukin (IL)-1β, IL-2, IL-6, IL-8, IL-10, matrix metalloproteinase (MMP)-2, MMP-8, MMP-9, and tumor necrosis factor (TNF)-α were measured using a Human Magnetic Luminex assay (R&D Systems, Minneapolis, MN). The differences in the levels of inflammatory mediators according to the presence or absence of ROP were compared. In patients who developed ROP, the level of MMP-2 in the AF was significantly increased (P = .011), whereas the levels of IL-10 and TNF-α were significantly decreased (P = .028 and .046, respectively) compared with those in infants who did not develop ROP. The levels of the other mediators were not significantly different between the 2 groups. Multivariate regression analysis showed that MMP-2 was a risk factor for the development of ROP (odds ratio, 2.445; 95% confidence interval, 1.170-5.106; P = .017). The concentration of MMP-2 in AF is an independent factor in the development of ROP. Further studies are needed to determine whether the levels of inflammatory mediators in AF affect the ROP severity.

Early detection and correlation of tear fluid inflammatory factors that influence angiogenesis in premature infants with and without retinopathy of prematurity

“…Various reports have also shown differences in the observation with reference to IL-6 and MCP1-CCL2 levels in ROP infants. Tear fluid IL-6 levels that were lower albeit insignificant in the current study were in line with other studies that reported no significant difference in its level in the vitreous humor,[ 21 ] tears,[ 21 ] serum,[ 51 ] urine,[ 51 ] and amniotic fluid[ 54 ] of ROP infants compared to controls. However, there were other studies that have reported IL-6 levels to be significantly higher in the vitreous humor,[ 9 ] aqueous humor,[ 50 ] serum,[ 55 ] blood,[ 49 ] cord blood plasma,[ 56 ] maternal plasma,[ 57 ] and amniotic fluid[ 53 ] of ROP infants.…”

“…A study reported that the levels of IL-8 in the urine were not significantly different between control pre-term infants and ROP infants. [ 51 ] Studies have also reported conflicting observations with reference to the levels of IL-8 in amniotic fluid, with one study demonstrating a significant increase[ 53 ] and the other with no significant difference[ 54 ] between controls and ROP infants. Various reports have also shown differences in the observation with reference to IL-6 and MCP1-CCL2 levels in ROP infants.…”

Inflammatory Cytokines in Tear Fluid as Potential Biomarkers for Retinopathy of Prematurity

“…The extraocular sites that been used to investigate changes in the in ammatory cytokines include the sera 11,26 , umbilical cord blood 27,28,29,30 , amniotic uid 31,32 , and feces 33 . These studies have reported high levels of CCL2 29 and VEGF 34 and low levels of insulin-like growth factor I (IGF-1) 11 in the sera.…”

Systemic Cytokines in Retinopathy of Prematurity

“…However, TNF-α also has paradoxical anti-inflammatory properties [ 55 , 56 ]. Some authors discovered low TNF-α levels in the amniotic fluid retrieved during cesarean delivery correlating with the development of ROP in preterm infants [ 57 ]. Others found no difference in TNF-α levels in umbilical cord blood between ROP and control groups [ 58 ].…”