Association of pro- and anti-inflammatory cytokines in preeclampsia

J Clin Lab Anal. 2019 May;33(4):e22834. doi: 10.1002/jcla.22834. Epub 2019 Jan 21.


Introduction: The pro- and anti-inflammatory cytokines play crucial role in the development and functions of placenta. Any changes in these cytokines may be associated with many pregnancy-related disorders like preeclampsia. Therefore, the present study is aimed to study the expression of pro-inflammatory (TNF-α, IL-6) and anti-inflammatory (IL-4, IL-10) cytokines in placenta and serum of preeclamptic pregnant women.

Material and methods: For this study, a total of 194 cases of preeclamptic and control cases were enrolled in two Groups as per the gestational age that is, Group I (28-36 weeks) and II (37 weeks onwards). The number of samples was 55 in Group I and 139 in Group II. The immunohistochemistry (IHC) and enzyme-linked immunosorbent assay (ELISA) were conducted on placenta and serum of both preeclamptic and normal samples, respectively. IHC results were revalidated by reverse transcriptase PCR (RT-PCR).

Results: Both Groups (I, II) of preeclampsia showed amended levels of pro- and anti-inflammatory cytokines in placental tissues and serum samples. The levels of TNF-α and IL-6 were significantly increased in preeclamptic cases (P = 0.0001, P = 0.0001) while the IL-4 and IL-10 were downregulated (P = 0.0001, P = 0.0001) in comparison to control. In addition, a negative correlation was also observed between the two in preeclampsia (P = 0.0001).

Conclusion: The balanced ratio of pro- and anti-inflammatory cytokines is essential to regulate the maternal inflammation system throughout pregnancy. Therefore, the gradual cytokine profiling of the pregnant women may be useful for the management of preeclampsia.

Keywords: IL-10; IL-4; IL-6; TNF-α; cytokines; placenta; preeclampsia; serum.

MeSH terms

  • Biomarkers / blood
  • Cytokines / blood
  • Cytokines / metabolism*
  • Enzyme-Linked Immunosorbent Assay
  • Female
  • Humans
  • Inflammation / metabolism
  • Interleukin-10 / blood
  • Interleukin-10 / genetics
  • Interleukin-10 / metabolism
  • Interleukin-4 / blood
  • Interleukin-4 / genetics
  • Interleukin-4 / metabolism
  • Interleukin-6 / blood
  • Interleukin-6 / genetics
  • Interleukin-6 / metabolism
  • Placenta / cytology
  • Placenta / metabolism*
  • Pre-Eclampsia / blood
  • Pre-Eclampsia / metabolism*
  • Pregnancy
  • ROC Curve
  • Transcriptome
  • Tumor Necrosis Factor-alpha / blood
  • Tumor Necrosis Factor-alpha / genetics
  • Tumor Necrosis Factor-alpha / metabolism


  • Biomarkers
  • Cytokines
  • IL10 protein, human
  • IL4 protein, human
  • IL6 protein, human
  • Interleukin-6
  • TNF protein, human
  • Tumor Necrosis Factor-alpha
  • Interleukin-10
  • Interleukin-4

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