Steinborn A, Sohn C, Sayehli C, Niederhut A, Schmitt E, Kaufmann M
Department of Obstetrics and Gynecology, J.-W. Goethe-University of Frankfurt, Frankfurt/Main, Germany.
Clin Immunol. 2001 Sep;100(3):305-13. doi: 10.1006/clim.2001.5081.
The maternal syndrome of preeclampsia is an exclusively pregnancy-related illness involving multiple organs and severe forms may be complicated by HELLP (hemolysis, elevated liver enzymes, low platelets) syndrome. Recently, it has been proposed that both normal pregnancy and preeclampsia are associated with a systemic activation of the nonspecific maternal immune system and that, in particular, monocytes have a central role in the adjustment of maternal immune functions in pregnancy. Here we have investigated the role of the fetal nonadaptive immune system in normal term delivery, uncontrollable preterm labor, and preeclampsia. We demonstrate that spontaneous delivery at term as well as preterm occurrence of preeclampsia or HELLP syndrome are accompanied by an increased intracellular production of IL-6 in fetal monocytes, indicating strong activation of this cell type. In contrast, we show that elective cesarean delivery at term in the absence of labor or preterm delivery due to uncontrollable labor are not accompanied by an increased production of IL-6 in these cells. These results suggest that increased IL-6 synthesis in fetal monocytes may be a process occurring in association with normal spontaneous term delivery and that this process obviously occurs in early pregnancy in case of preeclampsia. Therefore, we propose that the activation of fetal monocytes as effectors of the innate immunity may be involved in mechanisms inducing spontaneous term delivery and that the occurrence of preeclampsia may be based on dysfunctions of probably both the maternal and the fetal innate immune system.
子痫前期的母体综合征是一种仅与妊娠相关的疾病，涉及多个器官，严重形式可能并发HELLP（溶血、肝酶升高、血小板减少）综合征。最近，有人提出正常妊娠和子痫前期均与母体非特异性免疫系统的全身激活有关，特别是单核细胞在妊娠期间母体免疫功能的调节中起核心作用。在此，我们研究了胎儿非适应性免疫系统在足月分娩、不可控早产和子痫前期中的作用。我们证明，足月自然分娩以及子痫前期或HELLP综合征的早产均伴随着胎儿单核细胞内IL-6产生增加，表明这种细胞类型被强烈激活。相比之下，我们表明足月择期剖宫产在无分娩或因不可控分娩而早产的情况下，这些细胞中IL-6的产生并未增加。这些结果表明，胎儿单核细胞中IL-6合成增加可能是与正常足月自然分娩相关的一个过程，并且在子痫前期的情况下，这个过程显然发生在妊娠早期。因此，我们提出胎儿单核细胞作为先天免疫效应器的激活可能参与诱导足月自然分娩的机制，子痫前期的发生可能基于母体和胎儿先天免疫系统的功能障碍。
