Serum levels of cytokines in preeclampsia and HELLP syndrome
Introduction: Preeclampsia is a major cause of maternal and neonatal morbidity and mortality. A severe form of preeclampsia is the HELLP (Hemolysis, Elevated Liver enzymes, and Low Platelets) syndrome. Cytokines play a key role in the pathogenesis of preeclampsia. It is unknown if differences in levels of cytokines exist in preeclampsia and HELLP syndrome.
Objective: To estimate levels of pro-inflammatory and anti-inflammatory cytokines in preeclampsia and HELLP.
Methods: Mothers with preeclampsia (n=38), HELLP syndrome (n=35 and normotensive pregnancies (n=37) were, recruited from the Obstetrics Department at the Foothills Medical Centre . Levels of pro-inflammatory cytokines IFN-γ, 1L-1β, 1L-6, IL-8, TNF-α and anti-inflammatory cytokine IL-10 were measured by enzyme-linked immunosorbent assays . Exclusion criteria included maternal fever, chorioamnionitis, multiple gestation, diabetes mellitus, maternal renal, cardiovascular, endocrine or auto-immune disease, chronic hypertension, substance abuse, TORCH infections, PROM (premature rupture of membranes), and PPROM (preterm premature rupture of membranes), congenital malformations, multiple pregnancy. Kruskal-Wallis test was used for statistical analysis as appropriate. P-value of <0.05 was considered significant. Bonferroni correction was used post hoc for multiple comparisons.
Results: Please see tables.
Conclusions: 1. Compared to mothers with preeclampsia, we found higher levels of IL-10, IL8, IFN-γ in mothers with HELLP syndrome. 2. Our data suggests HELLP and preeclampsia have distinct cytokine profiles. 3. These cytokines may be useful for early detection of HELLP in mothers with preeclampsia.