INTERLEUKIN-6, TUMOR-NECROSIS-FACTOR AND SOLUBLE TUMOR-NECROSIS-FACTOR RECEPTORS IN WOMEN WITH PREECLAMPSIA

Objectives Generalised maternal endothelial cell dysfunction appears t o be an underlying problem in pre-eclampsia presumed to be caused, dir ectly or indirectly, by one or more circulating factors derived from t he placenta. Recently it has been suggested that tumour necrosis facto r (TNF) may play an important role in pre-eclampsia and contribute to endothelial activation. This study was designed to investigate this pr oposal. Design Plasma TNF-alpha, IL-6 and both forms of soluble TNF re ceptors (p55 and p75 TNF-R) have been measured by ELISA in 31 pre-ecla mptic patients and 31 pregnant controls matched for age, parity and ge stational age. Results Levels of IL-6, TNF-alpha and soluble TNF-R (p5 5 and p75) were significantly higher in preeclamptic patients, compare d with age and gestation matched controls with a wide variation in lev els between pre-eclamptic individuals. There was a correlation between levels of IL-6 and TNF or TNF-R and between TNF and TNF-R levels. How ever, when the pre-eclamptic patients were subdivided on the basis of the severity of their disease, the median values of plasma concentrati ons of IL-6, TNF-alpha and TNF-R were all higher in the group with low er platelet counts. Conclusions These new findings are consistent with the concept that the maternal syndrome of preeclampsia is associated with endothelial dysfunction and provide evidence that at least part o f this dysfunction could arise from excessive release of TNF-alpha int o the circulation.