Serum levels of tumor necrosis factor- α and interleukin -10, and their clinical correlates in women with pre-eclampsia/eclampsia in Ahmadu Bello University Teaching Hospital

Abstract

Background: Pre-eclampsia is a pregnancy-specific disorder characterized by the onset of hypertension and proteinuria after the 20th week of gestation. It is characterized by an exaggerated maternal inflammatory response with a preponderance of cell-mediated immune response. Tumor necrosis factor-alpha (TNF-α) is a pro-inflammatory cytokine that induces apoptosis and restrains differentiation. Defective trophoblastic invasion is now identified as the key etiology of pre-eclampsia. The objective of this study was to determine the serum levels TNF-α and interleukin 10 (IL-10) in women with pre-eclampsia/eclampsia and the relationship between these cytokines and the severity of the disease. Patients and Method: This was a case-control study carried out in Ahmadu Bello University Teaching Hospital, Zaria, Kaduna State, Forty-eight patients with a diagnosis of pre-eclampsia/eclampsia were recruited as cases. The diagnosis was according to the International Society for the Study of Hypertension in Pregnancy (ISSHP) criteria. For each case, a healthy pregnant control was selected, after matching for age, gestational age, and parity. Blood samples were taken and assayed for TNF-α and IL 10 using enzyme-linked immunosorbent assay. Data were analyzed using SPSS v 20. A P value Results: The prevalence of pre-eclampsia/eclampsia in ABUTH Zaria is 5.1%. Nulliparous women constituted 65.9% of the patients. Thirty-five percent of the women were between 20 and 24 years of age. The mean serum levels of TNF-α in women with pre-eclampsia/ eclampsia and controls were 294.8 ± 146 pg/mL and 176 ± 35.5 pg/mL, respectively. The mean serum levels of IL-10 in patients and controls with pre-eclampsia were 13.9 ± 5.7 pg/mL and 33.0 ± 11.0 pg/mL, respectively. The levels of TNF-α correlated positively with the severity of the disease. The serum levels of IL-10 did not correlate with disease severity. Conclusion: The prevalence of pre-eclampsia/eclampsia is high in ABUTH. The disease is characterized by an exaggerated inflammatory response in women in Zaria. Use of anti- TNF-α drugs may possibly have a role in the prevention of pre-eclampsia.