CIRCULATING BIOACTIVE TUMOR-NECROSIS-FACTOR-ALPHA, TUMOR-NECROSIS-FACTOR-ALPHA RECEPTORS, FIBRONECTIN, AND TUMOR-NECROSIS-FACTOR-ALPHA INDUCIBLE CELL-ADHESION MOLECULE VCAM-1 IN UNCOMPLICATED PREGNANCY

OBJECTIVES: Our goal was to assess in a longitudinal study of uncompli cated pregnancy the course of maternal plasma concentrations of the bi oactive cytokine tumor necrosis factor-alpha, the soluble tumor necros is factor-alpha receptors sTNFRI and sTNFRII, the soluble cell adhesio n molecule sVCAM-1, and circulating fibronectin. STUDY DESIGN: Blood w as collected from 22 healthy pregnant women at 7 to 17, 18 to 22, 23 t o 28, and 30 to 36 weeks' gestation and post partum. Plasma samples we re measured by bioassay for bioactive tumor necrosis factor-alpha, by immunoassay for sTNFRI, sTNFRII, and VCAM-1, and by radial immunodiffu sion for circulating fibronectin, and data were statistically analyzed . RESULTS: Plasma concentrations of all variables were significantly l inked with gestational age, Levels of bioactive tumor necrosis factor- alpha and sTNFRII showed a parallel rise in the second trimester and a decrease thereafter. Values for sTNFRI and sTNFRII and for these rece ptors and VCAM-1 were correlated, a weak correlation between bioactive tumor necrosis factor-alpha and sTNFRII was observed, and no correlat ion between circulating fibronectin and other variables was apparent. CONCLUSIONS: All variables studied exhibited a characteristic pattern depending on gestational age, which supports the concept of a physiolo gic rule of tumor necrosis factor-alpha in pregnancy.