AMNIOTIC-FLUID INTERLEUKIN-6 IN PRETERM LABOR - ASSOCIATION WITH INFECTION
AMNIOTIC-FLUID INTERLEUKIN-6 IN PRETERM LABOR - ASSOCIATION WITH INFECTION
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DOI：
10.1172/jci114583
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发表时间：
1990-05-01
影响因子：
15.9
通讯作者：
SEHGAL, PB
中科院分区：
文献类型：
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作者：
ROMERO, R;AVILA, C;SEHGAL, PB
为了评价IL-6是否参与宫内感染的宿主反应，我们研究了羊水（AF）中IL-6的生物活性和亚型。使用了两种不同的IL-6测定法：肝细胞刺激因子测定法（在Hep 3B 2细胞中）和SDS-PAGE/免疫印迹测定法。对205例房颤患者进行了IL-6测定。样本来自妊娠中期（n = 25）、足月无分娩（n = 31）、足月活跃分娩（n = 40）和早产患者（n = 109）。在有羊膜腔感染的早产孕妇中观察到的AF IL-6水平高于无羊膜腔感染的早产孕妇（中位数= 375 ng/ml，范围= 30-5000，分别为P < 0.0001）。23-25-和28-30-kD IL-6种类可以在直接对来自羊膜内感染患者的AF的10 μ l等分试样进行的SDS-PAGE免疫印迹中容易地检测到。在培养阴性房颤的早产妇女中，那些对随后的保胎治疗无效的妇女比那些对治疗有反应的妇女有更高的房颤IL-6浓度（中位数分别为50 ng/ml和1.2 ng/ml，P < 0.05）。只有低水平的IL-6检测到AF从正常妇女在中期和晚期妊娠。从足月无分娩的择期剖宫产妇女（n = 11）的胎盘中获得的蜕膜组织外植体产生IL-6，以响应细菌内毒素。在一项初步研究中，在56名连续入院的早产妇女中测定了AF IL-6。所有AF IL-6升高（临界值= 46 ng/ml）的患者（n = 10）均产下早产儿。这10例患者中有4例AF微生物培养阳性。这些研究暗示IL-6在宿主对宫内感染的反应中，并表明AF IL-6水平的评估可能对早产妇女的管理具有诊断和预后价值。
To evaluate whether IL-6 participates in the host response to intrauterine infection, we studied IL-6 bioactivity and isoforms in amniotic fluid (AF). Two different assays for IL-6 were used: the hepatocyte stimulating factor assay (in Hep3B2 cells) and the SDS-PAGE/immunoblot assay. IL-6 determinations were perforemd in 205 AF samples. Samples were obtained from patients in the midtrimester of pregnancy (n = 25), at term with no labor (n = 31), at term in active labor (n = 40), and from patients in preterm labor (n = 109). Higher AF IL-6 levels were observed in women in preterm labor with intraamniotic infection than in women in preterm labor without intraamniotic infection (median = 375 ng/ml, range = 30-5000, respectively, P < 0.0001). The 23-25- and 28-30-kD IL-6 species could be readily detected in SDS-PAGE immunoblots performed directly on 10-.mu.l aliqouts of AF from patients with intraamniotic infection. Among women in preterm labor with culture-negative AF, those who failed to respond to subsequent tocolytic treatment had higher AF IL-6 concentrations than those who responded to therapy (median = 50 ng/ml vs. median = 1.2 ng/ml, respectively, P < 0.05). Only low levels of IL-6 were detected in AF obtained from normal women in the midtrimester and third trimester of pregnancy. Decidual tissue explants obtained from the placentas of women undergoing elective cesarean section at term without labor (n = 11) produced IL-6 in response to bacterial endotoxin. In a pilot study, AF IL-6 was determined in 56 consecutive women admitted with preterm labor. All patients (n = 10) with elevated AF IL-6 (cutoff = 46 ng/ml) delivered a premature neonate. 4 of these 10 patients had positive AF cultures for microorganisms. These studies implicate IL-6 in the host response to intrauterine infection and suggest that evaluation of AF IL-6 levels may have diagnostic and prognostic value in the management of women in preterm labor.