Prognostic Biomarkers of Pre-Eclampsia in Pregnant Women

Abstract

Summary. According to various authors, the incidence of preeclampsia (PE) in pregnant women in our country ranges from 8 to 20% and does not tend to decrease. It has been shown that the pathogenesis of preeclampsia fits into the systemic inflammatory response syndrome with disturbances in the immune system and an imbalance in cytokine regulation. The aim of the study was to study pro-inflammatory (IL-1β, IL-6, IL-8) and anti-inflammatory (IL-4, IL-10) cytokines in women with preeclampsia of varying severity. Material and methods. We examined 76 pregnant women with PE aged from 24 to 36 years at a gestation period of 28–38 weeks. Of these, 42 developed PE (main group), and 34 women had no symptoms of PE (comparison group). 28 women with a physiological pregnancy formed the control group. The levels of pro- and anti-inflammatory cytokines (IL-1β, IL-6, IL-8, IL-4 and IL-10) in blood serum were studied by ELISA. Results. In pregnant women with PE upon admission to the hospital, the blood serum levels of IL-1β increased by 1.3 times (p < 0.05), IL-8 by 7 times (p < 0.001) and a decrease in the level of IL-4 by 2 times (p < 0.001). And in pregnant women without signs of PE, these changes in cytokine synthesis were less pronounced (p < 0.01). Conclusion. Maintaining a dynamic balance in the cytokine system plays an important role for the normal development of pregnancy. Th2-type cytokines promote normal trophoblast differentiation and its full invasion and, therefore, mediate the prolongation of physiological pregnancy. Switching to the synthesis of Th1-type cytokines and their enhanced production leads to disruption of trophoblast differentiation and invasion with the development of pregnancy pathology.