Serum cytokines in Maltese women with miscarriage

Abstract

Introduction: Spontaneous miscarriages include pregnancy loss from the time of conception up to 24 weeks of gestation. More than 50% of first trimester miscarriages and 30% of second trimester miscarriages are caused by fetal chromosomal aberrations. It is assumed that chromosomally abnormal miscarriages are affected through different mechanisms than chromosomally normal miscarriages. Karyotypically abnormal miscarriages may be due to local functional disturbances while normal karyotype miscarriages may be the result of feta! rejection due to a maternal systemic inflammation. Cytokines play a crucial role in the maintenance of pregnancy by regulating and modulating the immune system. Recent studies reveal that in normal karyotype miscarriages there is cytokine production in the maternal circulation linked to a Thelper (TH)-1 cell type immunity. Pro-inflammatory cytokines tumor necrosis factor a (TNF-a) and interferon y (IFN-y) are amongst the cytokines that are considered detrimental to pregnancy, while anti-inflammatory cytokines interleukin (IL)-4, 6 and 10 enhance embryonic development. Methods: In total, 25 miscarriages have been karyotyped using conventional cytogenetic techniques. Maternal sera collected at the time of miscarriage (n=6o) will be assayed with Quantikine® ELISA kits to detect, quantify and compare serum cytokine levels: TNFa, IFNy, 1110 and transforming growth factor B1 (TGFB1). Comparison will be made between serum cytokine levels in women undergoing miscarriage (n=40), women experiencing recurrent miscarriage (RM) (n=20) and women with a histo1y of RM (n=20). Conclusion: The karyotype and cytokine results will be presented to establish a possible correlation between cytokine levels in women experiencing miscarriage or RM, and fetal karytope.