Abstract
During pregnancy cytokines and inflammatory mediators stimulate the expression of prostaglandin, the levels of which determine the onset of labor. The aim of this work was to study interleukin IL-1beta, IL-6 and IL-8 levels in the vaginal discharge, serum and urine of pregnant women with genitourinary infection before and after specific treatment. One hundred and fifty-one patients were studied during the second or third trimester of their pregnancy. The selected patients were: healthy or control group (n = 52), those with bacterial vaginosis (n = 47), those with vaginitis (n = 37), those with asymptomatic urinary infection (n = 15) and post-treatment. The level of cytokines was assayed by ELISA test. The Mann-Whitney U-test was used for statistical analysis. The IL-1beta levels in vaginal discharge were: control 103.5 +/- 24.2 pg/ml, bacterial vaginosis 1030 +/- 59.5, vaginitis 749.14 +/- 66.7l ( p < 0.0001), post-treatment 101.4 +/- 28.7. IL-6 values were similar in both control and infected groups, and there were no patients with chorioamnionitis. In vaginal discharge IL-6: control 14.2 +/- 3.9 pg/ml, bacterial vaginosis 13.2 +/- 3.8, vaginitis 13 +/- 4.2. IL-8 levels were: control 1643 +/- 130.3 pg/ml, bacterial vaginosis 2612.7 +/- 257.7, vaginitis 3437 +/- 460 (p < 0.0001), post-treatment 1693 +/- 126.6. In urine the results were: control 40.2 +/- 17 pg/ml, asymptomatic urinary infection 1200.7 +/- 375 (p < 0.0001). In patients with therapeutic success both IL-1beta and IL-8 returned to normal levels. Genitourinary infections induce a significant increase in IL-1beta and IL-8 levels in vaginal secretions, and IL-8 in urine as well. Both cytokines could be useful as evolutive markers of infection.
Highlights
During pregnancy, inflammatory mediators, such as interleukin-1b (IL-1b) and tumor necrosis factor-a (TNF-a) directly stimulate the expression of prostaglandin, the levels of which determine the onset of labor
The patients were classified into the following groups by clinical examination and laboratory diagnosis: healthy pregnant women n = 52, pregnant women with bacterial vaginosis (BV) n = 47, pregnant women with vaginitis (V) n = 37, and pregnant women with asymptomatic urinary infection (AUI) n = 15
Important advances have been achieved in understanding the role that cytokines, cytokine receptors and soluble mediators play in different tumor, infectious or inflammatory pathologies, since they are, in many cases, involved in the pathogenesis of such diseases [10,11,12,13,14]
Summary
Inflammatory mediators, such as interleukin-1b (IL-1b) and tumor necrosis factor-a (TNF-a) directly stimulate the expression of prostaglandin, the levels of which determine the onset of labor. These cytokines, together with IL-8, activate the secretion of IL-6 by deciduas and chorionic membrane cells encouraging the membranes to rupture. It has been demonstrated that during labor, cervical dilatation is associated with an increase in IL-1b and IL-8 concentrations in the lower uterine segment [1] It has been observed at experimental level that in normal conditions, the cervix fibroblast is responsible for IL-8 synthesis [2,3].
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