Westgren M, Ek S, Remberger M, Ringden O, Stangenberg M
Department of Obstetrics and Gynecology, Huddinge Hospital, Karolinska Institute, Stockholm, Sweden.
Obstet Gynecol. 1995 Aug;86(2):209-13. doi: 10.1016/0029-7844(95)00132-b.
To determine fetal serum and amniotic fluid (AF) levels of interleukin (IL)-3, IL-6, granulocyte-macrophage colony-stimulating factor, stem cell factor, and erythropoietin, and to explore the relationship between cytokines and hemoglobin concentration, white blood cell count (WBC), and platelet count in fetuses affected by Rh immunization.
Thirty-four consecutive Rh-immunized patients in gestational weeks 19-33 were included. All patients were investigated by funipuncture and 13 by amniocentesis. The levels of IL-3, IL-6, granulocyte-macrophage colony-stimulating factor, stem cell factor, and erythropoietin were estimated using commercially available immunoassays.
There was a significant correlation between erythropoietin concentrations in fetal serum and AF (r = 0.54, P < .05), whereas none of the other cytokines showed a positive correlation between these two compartments. Fetal serum contained higher concentrations of IL-3, granulocyte-macrophage colony-stimulating factor, stem cell factor, and erythropoietin compared with AF. In contrast, the IL-6 level was significantly higher in AF compared with fetal serum (P = .002). Erythropoietin and IL-3 levels were both negatively correlated with fetal hemoglobin concentrations (r = -0.75, P = .02, and r = -0.67, P = .045). The fetal WBC correlated significantly with the fetal serum concentration of granulocyte-macrophage colony-stimulating factor (r = 0.38, P = .04).
Human fetuses with anemia due to erythrocyte immunization exhibit an increased production of erythropoietin and IL-3. Other studied cytokines (such as stem cell factor, granulocyte-macrophage colony-stimulating factor, and IL-6) did not correlate with the degree of fetal anemia. Among the studied cytokines, only erythropoietin showed a positive correlation between fetal serum and AF.
测定胎儿血清和羊水（AF）中白细胞介素（IL）-3、IL-6、粒细胞-巨噬细胞集落刺激因子、干细胞因子和促红细胞生成素的水平，并探讨细胞因子与受Rh免疫影响胎儿的血红蛋白浓度、白细胞计数（WBC）和血小板计数之间的关系。
纳入34例孕周为19 - 33周的连续Rh免疫患者。所有患者均接受脐血穿刺检查，13例接受羊膜腔穿刺检查。使用市售免疫分析法测定IL-3、IL-6、粒细胞-巨噬细胞集落刺激因子、干细胞因子和促红细胞生成素的水平。
胎儿血清和羊水中促红细胞生成素浓度之间存在显著相关性（r = 0.54，P <.05），而其他细胞因子在这两个部位之间均未显示出正相关性。与羊水相比，胎儿血清中IL-3、粒细胞-巨噬细胞集落刺激因子、干细胞因子和促红细胞生成素的浓度更高。相反，羊水中IL-6水平显著高于胎儿血清（P =.002）。促红细胞生成素和IL-3水平均与胎儿血红蛋白浓度呈负相关（r = -0.75，P =.02；r = -0.67，P =.045）。胎儿白细胞与胎儿血清中粒细胞-巨噬细胞集落刺激因子浓度显著相关（r = 0.38，P =.04）。
因红细胞免疫导致贫血的人类胎儿促红细胞生成素和IL-3的产生增加。其他研究的细胞因子（如干细胞因子、粒细胞-巨噬细胞集落刺激因子和IL-6）与胎儿贫血程度无关。在所研究的细胞因子中，只有促红细胞生成素在胎儿血清和羊水中显示出正相关性。
