Kusanovic Juan Pedro, Romero Roberto, Hassan Sonia S, Gotsch Francesca, Edwin Samuel, Chaiworapongsa Tinnakorn, Erez Offer, Mittal Pooja, Mazaki-Tovi Shali, Soto Eleazar, Than Nandor Gabor, Friel Lara A, Yoon Bo Hyun, Espinoza Jimmy
Perinatology Research Branch, NICHD/NIH/DHHS, Bethesda, Maryland, USA
J Matern Fetal Neonatal Med. 2007 Dec;20(12):867-78. doi: 10.1080/14767050701482993.
Women with preeclampsia and those who deliver small for gestational age (SGA) neonates are characterized by intravascular inflammation (T helper 1 (Th1)-biased immune response). There is controversy about the T helper 2 (Th2) response in preeclampsia and SGA. CD30, a member of the tumor necrosis factor receptor superfamily, is preferentially expressed in vitro and in vivo by activated T cells producing Th2-type cytokines. Its soluble form (sCD30) has been proposed to be an index of Th2 immune response. The objective of this study was to determine whether the maternal serum concentration of sCD30 changes with normal pregnancy, as well as in mothers with preeclampsia and those who deliver SGA neonates.
This cross-sectional study included patients in the following groups: (1) non-pregnant women (N = 49); (2) patients with a normal pregnancy (N = 89); (3) patients with preeclampsia (N = 100); and (4) patients who delivered an SGA neonate (N = 78). Maternal serum concentration of sCD30 was measured by a specific and sensitive enzyme-linked immunoassay. Non-parametric tests with post-hoc analysis were used for comparisons. A p value <0.05 was considered statistically significant.
(1) The median sCD30 serum concentration of pregnant women was significantly higher than that of non-pregnant women (median 29.7 U/mL, range 12.2-313.2 vs. median 23.2 U/mL, range 14.6-195.1, respectively; p = 0.01). (2) Patients with preeclampsia had a significantly lower median serum concentration of sCD30 than normal pregnant women (median 24.7 U/mL, range 7.6-71.2 vs. median 29.7 U/mL, range 12.2-313.2, respectively; p < 0.05). (3) Mothers with SGA neonates had a lower median concentration of sCD30 than normal pregnant women (median 23.4 U/mL, range 7.1-105.3 vs. median 29.7 U/mL, range 12.2-313.2, respectively; p < 0.05). (4) There was no significant correlation (r = -0.059, p = 0.5) between maternal serum sCD30 concentration and gestational age (19-38 weeks) in normal pregnant women.
(1) Patients with preeclampsia and those who deliver an SGA neonate had a significantly lower serum concentration of sCD30 than normal pregnant women. (2) This finding is consistent with the view that preeclampsia and SGA are associated with a polarized Th1 immune response and, perhaps, a reduced Th2 response.
子痫前期患者以及分娩小于胎龄（SGA）新生儿的女性具有血管内炎症特征（以辅助性T细胞1（Th1）为主导的免疫反应）。子痫前期和SGA中辅助性T细胞2（Th2）反应存在争议。CD30是肿瘤坏死因子受体超家族成员，在体外和体内优先由产生Th2型细胞因子的活化T细胞表达。其可溶性形式（sCD30）被认为是Th2免疫反应的指标。本研究的目的是确定正常妊娠以及子痫前期母亲和分娩SGA新生儿母亲的血清sCD30浓度是否发生变化。
这项横断面研究纳入了以下几组患者：（1）非孕妇（N = 49）；（2）正常妊娠患者（N = 89）；（3）子痫前期患者（N = 100）；（4）分娩SGA新生儿的患者（N = 78）。采用特异性和灵敏的酶联免疫吸附测定法测量母亲血清sCD30浓度。采用非参数检验及事后分析进行比较。p值<0.05被认为具有统计学意义。
（1）孕妇血清sCD30浓度中位数显著高于非孕妇（分别为中位数29.7 U/mL，范围12.2 - 313.2 vs.中位数23.2 U/mL，范围14.6 - 195.1；p = 0.01）。（2）子痫前期患者血清sCD30浓度中位数显著低于正常孕妇（分别为中位数24.7 U/mL，范围7.6 - 71.2 vs.中位数29.7 U/mL，范围12.2 - 313.2；p < 0.05）。（3）分娩SGA新生儿的母亲血清sCD30浓度中位数低于正常孕妇（分别为中位数23.4 U/mL，范围7.1 - 105.3 vs.中位数29.7 U/mL，范围12.2 - 313.2；p < 0.05）。（4）正常孕妇血清sCD30浓度与孕周（19 - 38周）之间无显著相关性（r = -0.059，p = 0.5）。
（1）子痫前期患者和分娩SGA新生儿的患者血清sCD30浓度显著低于正常孕妇。（2）这一发现与子痫前期和SGA与极化的Th1免疫反应相关且可能Th2反应降低的观点一致。
