POTENTIAL THERAPEUTIC USE OF CYTOKINES IN GYNECOLOGY AND OBSTETRICS

Therapeutic manipulation of cytokines may be accomplished by inhibitio n of a particular cytokine using an antagonist or by administering the cytokine itself. Cytokines appear to have a number of physiological r oles, and consequently therapeutic implications, in obstetrics and gyn aecology. In the central nervous system, interleukin-l (IL-I! decrease s gonadotropin releasing hormone and luteinising hormone levels and in creases prolactin levels. Interferon-alpha and -gamma and tumour necro sis factor-alpha have negative effects on sperm motility and penetrati on rates. Seminal IL-6 and IL-8 levels correlate negatively with ferti lity. IL-8 seems to be involved in periovulatory events by attracting and activating neutrophils that play a role in timely follicular ruptu re. Leukaemia inhibitory factor has been shown to be essential for bla stocyst implantation. Interleukin-l may be one of the signals for the onset of human parturition, and may also play a role in the initiation of preterm labour associated with intraamniotic infection. In a mouse model, pretreatment with subcutaneous IL-1 receptor antagonist (IL-1r a) prevented IL-l-induced preterm parturition, suggesting a role for t he use of anticytokine agents in the treatment of infection-associated preterm labour. IL-8 induces cervical ripening when applied locally t o the cervix in rabbits, which indicates its pivotal role in cervical maturation. The evaluation of cytokine levels, especially IL-l, may be used as a diagnostic tool to monitor osteoporosis, and drugs such as IL-1ra that interfere with cytokine action could provide new therapies for the effective management of postmenopausal osteoporosis.