DETERMINATION OF CYTOKINES AND CYTOKINE R ECEPTORS IN PRETERM LABOR

One of the leading causes of preterm labour is a subclinical intrauter ine infection. The diagnosis of this inapparent infection is an unsolv ed problem, because clinical parameters show the infection mostly too late and cannot be used for early detection of women at high risk for preterm labour. A prospective clinical study measuring cytokines and c ytokine receptor concentration in amniotic fluid from patients with pr eterm labour and preterm rupture of membranes (PROM) was undertaken to answer the question whether the amount of cytokines is positively cor related to the risk of preterm delivery. In 78 patients (43 controls, 23 patients with PROM, 7 with preterm labour and delivery < 37 weeks o f gestation, 7 with preterm labour and delivery at term) amniotic flui d was collected and the following cytokines were measured by an ELISA: IL1 beta, IL2, IL6, TNF alpha, IFN gamma, TNF receptor 55 und 75, IFN gamma receptor, IL2 receptor. We found significant, in some Gases hig hly significant differences in the cytokine content of amniotic fluid of patients with FROM compared with controls and patients with preterm labour and delivery before 37 weeks of gestation compared with contro ls. There were no differences between patients with preterm labour and delivery at term and controls. Amniotic fluid cultures were positive only in 20-25 % of the cases and therefore not a predictive sign. The determination of cytokines in amniotic fluid of patients with preterm labour seems to be a good marker to predict the risk of preterm delive ry. The development of a cytokine receptor antagonist as a causal ther apy strategy against preterm labour will be a project for the future t hat promises to be successful.