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PROBLEM: Circulating inflammatory cytokines have been implicated in the pathogenesis of preeclampsia. To test this hypothesis, we measured plasma levels of immunoreactive tumor necrosis factor (TNF)-alpha and -beta, interleukin (IL)-1 alpha and -beta, and IL-6 and -10 in women with preeclampsia, in women with transient gestational hypertension, and throughout normal pregnancy. METHOD OF STUDY: Enzyme-linked immunosorbent assays were used and subjected to extensive validation studies. RESULTS: The median concentration of plasma TNF-alpha was increased by twofold in women with preeclampsia compared with that in normal third-trimester pregnancy (P < 0.001) and in women with gestational hypertension (P < 0.04). The median concentration of plasma IL-6 was increased by threefold in women with preeclampsia compared with that in normal third-trimester pregnancy (P < 0.001) and increased twofold compared with that in women with gestational hypertension (P < 0.1). There were no significant differences observed in the levels of plasma IL-1 beta and IL-10 between the preeclamptic and other subject groups. The level of IL-1 beta, but not the levels of IL-10, TNF-alpha, or IL-6, was significantly changed during normal pregnancy compared with the nonpregnant condition manifesting an overall decline (P < 0.04). TNF-beta and IL-1 alpha were not detected in any samples, possibly because of the low sensitivity of these particular immunoassays. CONCLUSION: Elevated levels of TNF-alpha and IL-6 may contribute to the putative endothelial dysfunction of preeclampsia.
Conrad et al. (Sat,) studied this question.