Cytokine production in chorioamnionitis

Lymphohematopoietic cytokines play a significant role in many biological me chanisms including a number of reproductive processes such as ovulation, im plantation, placentation, cervical dilation and parturition. Recent experim ents have suggested that cytokines play a crucial role in the mechanisms of preterm labor and delivery, which an the leading causes of perinatal morbi dity and mortality. Growing evidence suggests that infection is deeply conc erned in the pathogenesis of preterm labor and delivery. Chorioamnionitis, a subset of intrauterine infection, has been identified in 20-33%, of women with preterm delivery, and the inflammatory and related cytokines, interle ukin-1 (IL-1), tumor necrosis factor-alpha (TNF-alpha), interleukin-6 (IL-6 ) and interleukin-8 (IL-8), showed substantial increases in the amniotic fl uid at women with intrauterine infection. Although the precise mechanism fo r chorioamnionitis-driven preterm labor mediated via cytokines is still unk nown, both IL-I and TNF-alpha along with IL-6 enhance prostaglandin product ion by human amnion cells, chorionic cells and decidual cells. Analysis of the regulatory sequences in the 5' upstream regions of receptor gene for hu man oxytocin, a potent uterotonic agent, suggests a close relationship betw een preterm labor and inflammatory cytokines through induction at the oxyto cin receptor. Prompt identification of the patients with intra-amniotic inf ection may be useful in clinical practice. At present, the measurement of I L-8 in maternal serum or the measurement of IL-6 in cervical secretion may be helpful as a non-invasive screening for chorioamnionitis. (C) 2000 Elsev ier Science Ireland Ltd. All rights reserved.