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Fetuses Delivered Following Preterm Prelabor Rupture of the Membranes are Capable of Stimulating a Proinflammatory Response in Endothelial Cells

Department of Obstetetrics and Gynaecology, Westmead Hospital, Darcy Road, Westmead, NSW 2145, Australia; neila{at}westgate.wh.usyd.edu.au

Jun Wang, PhD

Xin Wang, MS

Brian Trudinger, MD

Department of Obstetrics and Gynaecology, University of Sydney/Westmead Hospital, Westmead NSW, Australia

Objective: Preterm premature rupture of the membranes (PROM) has been attributed to ascending infection and a choriodecidual inflammatory response (ie, on the maternal side). However, on the fetal side those most at risk of morbidity have a systemic proinflammatory cytokine response. We have recently defined a similar proinflammatory response in pregnancies complicated by vascular disease on the fetal side of the placenta. A factor(s) present in fetal plasma from these pregnancies can stimulate human umbilical vein endothelial cells (HUVECs) to express mRNA for the proinflammatory cytokines, interleukin (IL)-6 and IL-8. The hypothesis of this study was that a similar factor(s) was present in preterm PROM.

Methods: A standard culture of HUVECs was incubated with fetal plasma, obtained immediately following delivery, from normal pregnancies delivering vaginally at term (n = 16) and pregnancies delivering following preterm PROM (n = 19). Expression of mRNA for IL-6 and IL-8 was assessed by reverse transcription polymerase chain reaction (RT-PCR) and standardized to GAPDH mRNA expression.

Results: Endothelial cell expression of IL-6 mRNA (median [25-75th centile] 0.295 [0.252-0.507] vs term vaginal delivery 0.208 [0.151-0.307]; P = .009) was enhanced in response to the fetal plasma from PROM cases compared to pregnancies delivering vaginally at term. In contrast, mRNA expression of IL-8 (median [25-75th centile] preterm PROM 0.41 [0.21-0.78] vs term vaginal delivery 0.49 [0.16-0.68]; P = .46) was not different in the two groups.

Conclusions: We have demonstrated that in fetuses delivered following preterm PROM there is a factor(s) capable of stimulating a local endothelial cell proinflammatory cytokine (IL-6) response. This factor(s) that we have demonstrated may be responsible for the increased cytokine production seen in fetuses with the fetal inflammatory response syndrome.

Key Words: Premature labor • preterm premature rupture of the membranes • proinflammatory cytokines • interleukin-6 • interleukin-8

Journal of the Society for Gynecologic Investigation, Vol. 12, No. 2, 118-122 (2005)
DOI: 10.1016/j.jsgi.2004.10.013


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