Kupferminc M J, Peaceman A M, Aderka D, Wallach D, Socol M L
Department of Obstetrics and Gynecology, Northwestern University Medical School, Chicago, Illinois, USA.
Obstet Gynecol. 1996 Sep;88(3):420-7. doi: 10.1016/0029-7844(96)00179-2.
To investigate whether serum and amniotic fluid (AF) levels of soluble tumor necrosis factor receptors and interleukin-6, markers of immune activation and endothelial dysfunction, are altered in patients with severe preeclampsia.
Plasma was collected before induction of labor, at delivery, and postpartum from 19 patients with severe preeclampsia. Amniotic fluid was also obtained in early labor from these patients. Similar samples were obtained from an antepartum control group matched for gestational age and a term control group without preeclampsia. All plasma and AF samples were assayed for p55 and p75 soluble tumor necrosis factor receptors and for interleukin-6 by specific enzyme-linked immunoassays. Levels in preeclamptic patients and the control groups were compared.
Levels of both receptors were significantly elevated in AF and all maternal plasma samples except those collected 24 hours postpartum for patients with preeclampsia relative to levels in controls. Interleukin-6 was detected more frequently and in higher concentrations in the plasma collected before labor for preeclamptic patients compared with controls, but no difference was noted in interleukin-6 detection rates or plasma concentrations at delivery. Conversely, AF concentrations of interleukin-6 were significantly reduced in patients with preeclampsia.
The increased levels of soluble tumor necrosis factor receptors found in patients with severe preeclampsia may represent a protective response to increased tumor necrosis factor activity and be a marker for immune activation. Increased interleukin-6 concentrations in maternal plasma before labor suggest the involvement of this cytokine as well in the altered immune response and its contribution to endothelial cell dysfunction.
研究可溶性肿瘤坏死因子受体和白细胞介素-6（免疫激活和内皮功能障碍的标志物）的血清和羊水水平在重度子痫前期患者中是否发生改变。
收集19例重度子痫前期患者引产、分娩时及产后的血浆。这些患者在产程早期也采集了羊水。从孕周匹配的产前对照组和无子痫前期的足月对照组获取类似样本。所有血浆和羊水样本通过特异性酶联免疫吸附测定法检测p55和p75可溶性肿瘤坏死因子受体以及白细胞介素-6。比较子痫前期患者和对照组的水平。
与对照组相比，子痫前期患者除产后24小时采集的样本外，羊水和所有母体血浆样本中两种受体的水平均显著升高。与对照组相比，子痫前期患者临产前采集的血浆中白细胞介素-6的检出频率更高且浓度更高，但分娩时白细胞介素-6的检出率或血浆浓度无差异。相反，子痫前期患者羊水中白细胞介素-6的浓度显著降低。
重度子痫前期患者中可溶性肿瘤坏死因子受体水平升高可能代表对肿瘤坏死因子活性增加的一种保护反应，并且是免疫激活的标志物。临产前母体血浆中白细胞介素-6浓度升高表明该细胞因子也参与了免疫反应改变及其对内皮细胞功能障碍的作用。
