T Helper Type1 (Th1),Th2 Cytotoxin And Premature Rupture Of Fetal Membranes

Objectives : 1.The Th-1 type cytotoxin Interferon-γ(IFN-γ)and Th-2 type cytotoxin Interleukin-10(IL-10) of peripheral blood in premature rupture of fetal membranes(PROM) patients were evaluated ,and some relations may be find out between these cytotoxins and PROM . 2.The cytotoxin IFN-γand IL-10 in fetal membranes were measured so That we can analyze associations of IFN-γ,IL-10 with PROM. To asses whether the increased inflammation in fetal membranes may be a major genesis ofPROM or an associated risk factor.3.To determine the correlation between inflammation and Th1 or Th2 Cytotoxin in this pathogenesis.Methods: The antecubital venous blood,amniochorion(fetal membranes ) samples were collected from 43 nulliparous women undergoing cesarean delivery before the onset of labour,including 16 cases preterm premature rupture of fetal membranes(pPROM),12cases premature rupture of fetal membranes of term(tPROM),15 cases term intact membranes as controls. We not only excluded women with other pregnancy complications including unexplained recurrent spontaneous abortion(URSA),pregnancy induced hypertension(PIH) and so on,clinical infections,recently having administered antibiotics;but also require all examined objections without undergoing smoking,amenia and subnutrition。(1)The enzyme-linked immunosorbent assay(ELISA)assayed the levels of Th1 type cytokine IFN-γandTh-2 type cytokine IL-10 in serum in order to show whether there are differences amongIFN-γ,IL-10 concentrations of every group(2)Fetal membranes histology after hematoryline and eosine(HE)Staining was performed to identify as the subclinical infection and the noninfection group (3)The expressions of IFN-γ,IL-10 in fetal membranes were documented with immunohistochemistry.Results were analyzed with q test;For these analyses,P<0.05 was considered statistically significant.Results: (1) The median serum and fetal membranes concentrations of IFN-γwere significantly higher in patients with pPROM than tPROM(P<0.05),meanwhile the median serum and fetal membranes concentrations of IFN-γwere significantly higher in patients with tPROM than in controls(P<0.05),whereas there were not significant differences in median serum concentrations of IL-10 between tPROM and controls(P>0.05), median serum concentrations of IL-10 in pPROM is higher than tPROM,controls. Meantime IL-10 in fetal membranes of pPROM were significantly lower than in controls and tPROM.(P<0.05). IL-10 in fetal membranes of tPROM were significantly lower Than in controls.(P<0.05).(2)Fetal membranes histology indicated: infection and inflammation in PROM group were significantly greater than in controls group(P<0.05),in contrast,no statistically significant differences between the pPROM and tPROM(P>0.05 ) .The expression values of IFN-γin serum or fetal membranes of subclinical infection group were significantly higher with of no infection group ( P < 0.05 ) ,however anti-inflammation cytokine IL-10 were significantly higher with no infection group(P<0.05)(.3)No infection group was divided into pPROM, tPROM and controls. IFN-γof pPROM,tPROM in serum or fetal membranes were significantly higher with of controls(P<0.05),meanwhile serum IL-10 were no statistically significant differences in pPROM,tPROM compaired with controls, but in fetal membranes IL-10 level of pPROM, tPROM were absolutely dropped than of controls. IFN-γof pPROM in serum or fetal membranes were significantly higher with of tPROM(P<0.05),meanwhile serum IL-10 in pPROM were significant higher than in tPROM ,but in fetal membranes IL-10 expression level of pPROM were more reduced than that of tPROM.Conclusion:(1) Premature rupture of fetal membranes is not only associated with increased cytotoxin IFN-γof peripheral blood and fetal membranes but also with reduced IL-10 of fetal membranes. However, it is not related to IL-10 of peripheral blood. (2)Whether fetal membranes is infected or not, median serum concentrations of IFN-γin PROM were higher than controls. We can speculate that there is obviously intravascular inflammation in PROM patients.(3)Chorioamnionitis have some common aspects with PROM in change of IFN-γ,IL-10 whether from peripheral blood or fetal membranes,so we can think both of them may be some kindred pathogenesis.