Abstract
Eclampsia (EC), a human pregnancy–specific-syndrome is the life-threatening occurrence of convulsion (s) in association with signs of preeclampsia (hypertension and proteinura). Eclampsia has remained a significant public health threat, contributing to maternal and prerinatal morbidity and mortality in Nigeria. However, the pathogenic mechanism of the disease is not fully understood. Disturbance of the cytokine equilibrium has been accused for many pathological disorders including EC. Thus the aim of this study was to analyze the maternal cytokines and pregnancy specific beta-1 glycoprotein in EC and compared results with those of normal healthy pregnant controls. Enzyme linkedimmunosorbent assay (ELISA) was used to measure levels ofpro-inflammatory cytokines (Tumor necrosis [TNF]-α, and interleukin [IL] -2), anti-inflammatory cytokines [IL-4 and IL-10] and pregnancy specific beta-1 glycoprotein (PSG-1) in the peripheral blood of patients with EC (n=38), normal healthy pregnant women [PC] (n=25) and compared withhealthy non pregnant women controls [NPC] (n=25). Women with malaria and human immunodeficiency virus infections were excluded from the study. The overall results (Mean ±SD) were: TNF-α (2.34 ±0.13 pg/ml) in EC was significantly higher than the mean values (2.25±0.07pg/ml and 2.24±0.10 pg/ml) in PC and NPC respectively. Furthermore, EC had higher TNF-α mean value compared with NPC (P<0.05). There was no statistical difference in mean IL-2 value between EC (1.69±0.17 Pg/ml), PC (1.71±0.0.09Pg/ml) and NPC (1.72±0.13Pg/ml) (P>0.05). The mean value of IL-10 was noted to be lower in EC (1.28±0.54Pg/ml) compared with: PC (1.58±0.61 Pg/ml) and NPC (2.06±0.08Pg/ml). No significant difference in IL-4 mean value exist between EC (2.45±0.10 Pg/ml) and NPC (2.45 Pg/ml) (P>0.05) but significant difference exist between EC and NPC (2.40±0.0 6Pg/ml) (P<0.05). The serum PSG-1 levels in EC (2.5±0.11 Pg/ml) and PC (2.5±0.03 Pg/ml) were similar and significantly higher than in NPC (0.06±0.020 Pg/ml) P<0.05. While a pro-inflammatory cytokine environment was demonstrated in EC, and decreased anti-inflammatory reactivity, EC was not associated with low levels of PSG-1. Further research is advocated to discover how anti-inflammatory cytokines could be exploited as a therapeutic agent for women at high risk of EC.
Highlights
In the recent decades, reports show that Eclampsia (EC) has assumed a public-health-threat dimension, both in the developing and developed countries [1]
The mean values of blood pressures and standard deviation were noted to be higher in EC (171.6±25.2mmHg; 110.0±10.7mmHg) compared with PC, (111.6±7.1mmHg; 79.5±11.3 mmHg) and NPC, (109.6±6.6 mmHg; 84.2±6.4 mmHg)
The study revealed significant increased in proinflammatory cytokine (TNF-α) level in EC, while the level of IL-2 component of the pro-inflammatory cytokine showed no significant difference in EC compare to the pregnant and non-pregnant controls
Summary
Reports show that Eclampsia (EC) has assumed a public-health-threat dimension, both in the developing and developed countries [1]. It is the most common medical complication of pregnancy accounting to about 2-8% of all pregnancies [2]. The incidence of EC continues to increase worldwide and especially, in Nigeria due to inadequate and poor utilization of maternal health care facilities. EC accounts for 50,000 maternal deaths in the world annually [4]. Thirty seven thousand (37,000) women in Nigeria die annually due to EC and eclampsia-related complications. In northern Nigeria, up to 40% of maternal death is due to EC [5]
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