The predominant Th1 cytokine profile in maternal plasma of preeclamptic women is not reflected in the choriodecidual and fetal compartments

OBJECTIVE: Human pregnancy disorders such as preeclampsia arc thought to involve variations in cytokine levels. It has been proposed that, in preeclamptic women, a balance favoring the Th1-type over the Th2-type cytokine profile determines local or systemic immunologic responses to pregnancy and that this may cause defective placental implantation and placental ischemia, which activate systemic endothelial cells. The purpose of this study was to determine whether cytokine expression differs in the maternal, choriodecidual, and fetal compartments, and between women with or without preeclampsia. METHODS: Plasma concentrations of interferon gamma (IFN gamma), interleukin (IL)-2, IL-4, and IL-10 were measured by enzyme-linked immunosorbent assay (ELISA) in samples obtained from maternal peripheral blood (MPB), choriodecidual (CD), and fetal cord (FC) blood compartments of 17 women with preeclampsia and in 15 normotensive women. Intracellular concentrations of IFN gamma and IL-2 in T lymphocytes were assessed by flow cytometry. RESULTS: Plasma IFN gamma concentrations in both MPB and CD compartments were significantly higher in preeclamptic than in normotensive women. Maternal plasma IL-4 concentration was significantly lower in preeclamptic than in normotensive women. Intracellular IFN gamma and IL-2 concentrations did not differ significantly between preeclamptic and normotensive women. CONCLUSIONS: The dominant Th1-type over Th2-type cytokine profile is evident in MPB, but riot in the CD and FC blood compartments. This might reflect the complex cytokine networks in the fetal-placental interface and might involve trophoblasts or decidual and endothelial cells, which could account for the increased plasma IFN gamma concentration and T-helper cell number. Copyright (c) 2005 by the Society for Gynecologic Investigation.