Potential role of interleukins-12 and 18 as predictors in infection induced premature rupture of membranes whether full term or preterm

Acute bacterial intraamniotic infections are by far the most important cause of perinatal morbidity and death. Although early diagnosis and aggressive treatment to decrease the ill effects of intra amniotic infection, this goal is frequently difficult to achieve because the infection may not be clinically apparent before delivery in all patients. In this respect, the current study was designed to asses the potential role of interleukins [1L]-12 and or 18 as a predictor of infection induced rupture membrane whether term or preterm. 75 pregnant women at labor were the subjects of the study. 25 preterm with premature rupture of membranes [PROM] were gp 1, 25 full term PROM were gp 2 and 25 full term with intact membranes were gp 3 [controls]. Bacterial cultures, Chlamydia, Mycoplasma and Ureaplasma were detected among the high vaginal swabs taken at the time of delivery. IL-12 and 18 were quantitated by commercial enzyme linked immu-nosorbant assay [ELISA] from cell culture supernates of milogcn stimulated whole peripheral blood obtained from all subjects at time of delivery. Results revealed a significant association of bacterial infections and IL-12 and 18 with PROM deliveries [whether preterm or term] compared to the controls. A significant increase in IL-12 and 18 were observed among preterm cases than full term ones and among positive bacterial culture cases compared to negative culture ones. The highest interleukin values were with ordinary bacterial infections and the least were with mycoplasmal and ureaplasmal ones. IL-18 values were significantly higher than IL-12 levels. So, we can conclude that IL-18 measurement could be a marker of infection induced PROM

role of cytomegalovirus [CMV] and cytokines in recurrent spontaneous abortions

The present study aimed at evaluating the role of CMV by polymerase chain reaction [PCR] in peripheral white blood cells and cytokines such as tumor necrosis factor alpha [TNF], interferon gamma [IFN] and interleukins [IL] IL-10 and IL-12 in cultured supernatants of nitrogen stimulated peripheral blood mononuclear cells by enzyme linked immunosorbent assay [ELISA] among cases suffering from recurrent spontaneous abortion. The study was conducted on 90 subjects who were divided into: Group 1 including 40 patients who were second trimester unexplained aborters; group 2 including 40 patients who were second trimester aborters of known gynecologic etiology and group 3 including 10 patients who were healthy pregnant controls of matched age. CMV was detected in 30% among group 1 which was significantly higher than both groups 2 and 3 [10%]. Also, CMV was highly significantly associated with the number of abortions [mean = 7.8] among group 1 than group 2 [mean = 4]. As regards the cytokines studied, TNF revealed the highest levels [mean = 2600 pg/ml] among group 1 and the least was IL-10 [mean = 30.25 pg/ml] with IFN and IL-12 in between and the difference was statistically significant. TNF, IFN and IL-12 revealed a significantly positive correlation to number of spontaneous abortions [groups 1, 2], whereas IL-10 revealed significantly negative correlation to the same groups. In conclusion, CMV should be routinely screened by PCR in peripheral white blood cells of all recurrent spontaneous abortion cases. Also, future immunotherapy by cytokines, such as IL-10 or anti-TNF or anti-IL-12, should be tried first experimentally then later on human volunteers to prevent recurrent spontaneous abortion