The Predominant Thi Cytokine Profile in Maternal Plasma of Preeclamptic Women Is Not Reflected in the Choriodecidual and Fetal Compartments

OBJECTIVE: Human pregnancy disorders such as preeclampsia are thought to involve variations in cytokine levels. It has been proposed that, in preeclamptic women, a balancefavoring the Th 1-type over the Th2-type cytokine profile determines local or systemic immunologic responses to pregnancy and that this may cause defective placental implantation and placental ischemia, which activate systemic endothelial cells. The purpose of this study was to determine whether cytokine expression differs in the maternal, choriodecidual, and fetal compartments, and between women with or without preeclampsia. M.ETHODS: Plasma concentrations of interferon gamma (IFNy), interleukin (IL)-2, IL-4, and IL- 10 were measured by enzyme-linked immunosorbent assay (ELISA) in samples obtained from maternal peripheral blood (MPB), choriodecidual (CD), andfetal cord (FC) blood compartments of 17 women with preeclampsia and in 15 normotensive women. Intracellular concentrations of IFNy and IL-2 in T lymphocytes were assessed by flow cytometry. REsIuLTS: Plasma IFNy concentrations in both MPB and CD compartments were significantly higher in preeclamptic than in normotensive women. Maternal plasma IL-4 concentration was significantly lower in preeclamptic than in normotensive women. Intracellular IFNy and IL-2 concentrations did not differ signficantly between preeclamptic and normotensive women. CONCLUSIONS: The dominant Th 1-type over Th2-type cytokine profile is evident in MPB, but not in the CD and FC blood compartments. This might reflect the complex cytokine networks in thefetal-placental interface and might involve trophoblasts or decidual and endothelial cells, which could accountfor the increased plasma IFNy concentration and T-helper cell number. (J Soc Gynecol Investig 2005; 12