Effects of various cytokines on the fimctions of trophblasts in the placenta in complicated pregnancies

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Serum levels of tumor necrosis factor-α (TNF-α), Th1 cytokine, were higher in preeclampsia than in normal pregnancies. However, serum levels of interleukin-6 (IL-6), Th2 cytokine, and both TNF-α and IL-6 levels in the placenta did not differ between the two groups. These findings suggest that serum TNF-α is involved in the pathophysiology of preeclampsia but that in the placenta neither TNF-α nor IL-6 play an important role. Amniotic fluid IL-6 levels did not differ between the two groups, suggesting that IL-6 is not involved in the pathophysiology of this condition. Significantly lower birth weights of neonates were seen in preeclampsia compared with those in normal pregnancies. Thus, placental dysfunction might be occurred in preeclampsia. However, IL-6 did not play an important role in the placental dysfunction. Amniotic fluid macrophage colony-stimulating factor (M-CSF) concentrations were significantly higher in women who delivered small-for-gestational-age (SGA) infants than in women who delivered appropriate-for-gestational-age (AGA) infants. Excessive concentrations of M-CSF in amniotic fluid via amniotic membranes may be highly related to immunological abnormalities contributing to low birth weight of neonates. There was no significant increase in granulocyte-macrophage colony-stimulating factor (GM-CSF) levels in amniotic fluid during labor compared to that before the onset of labor. Thus, GM-CSF in amniotic fluid may not promote the onset of labor at term and/or term labor contributing to subsequent delivery may not induce the production and secretion of GM-CSF into amniotic cavity. Amniotic fluid M-CSF concentrations were significantly higher in term gravidas than in women at 17 weeks of gestation. This finding suggests that elevated levels of M-CSF in amniotic fluid have an important immunological function in the maintenance of pregnancy and fetal growth.