ABSTRACT
The purpose of this study was to investigate the effect of vaginal progesterone on endocervical cytokine concentration in women at risk of threatened abortion. One hundred and sixty pregnant women with clinical symptoms of threatened abortion before the 20th week of pregnancy were randomly assigned to receive vaginal progesterone or placebo. Cervical fluids were collected and endocervical concentrations of different cytokines (IFNγ, TNFα, IL-8, IL-10 and IL-12) were analyzed before and one week after progesterone or placebo treatment. A significant decrease in IFNγ and increase in IL-10 in endocervical fluid was seen when the values were compared before and after progesterone treatment. However, there were no significant differences in pregnancy outcomes between the placebo and progesterone groups. We conclude that despite the failure of vaginal progesterone treatment to improve pregnancy outcomes, progesterone can induce a shift in the concentration of cytokines in endocervical secretions.
Subject(s)
Abortion, Spontaneous/drug therapy , Cervix Uteri/immunology , Cytokines/immunology , Progesterone/administration & dosage , Vagina/immunology , Abortion, Spontaneous/immunology , Administration, Intravaginal , Adult , Female , Humans , Middle Aged , Pregnancy , Progesterone/adverse effects , Risk , Th1-Th2 Balance , Treatment Outcome , Young AdultABSTRACT
BACKGROUND: There are strong evidences suggesting the secretion of different cytokines in cervical fluid during preterm labor. Betamethasone is widely administered for several reasons in preterm conditions. OBJECTIVE: To Investigate the possible effect of betamethasone on endocervical cytokine concentration of women at risk of preterm labor. METHODS: In a randomized clinical trial of 80 prime-gravid women in preterm labor between 34 and 37 weeks of gestation, cervical fluids were collected. Endocervical concentration of inflammatory cytokines were analyzed before and 48 hours after betamethasone treatment for the evaluation of IL-8, IL-17, IFN-γ and TGF-ß. Wilcoxon and Mann-Whitney tests were employed for statistical analysis. χ2 and Student's t tests were used whenever needed. RESULTS: All the measured cytokines showed significant changes in the betamethasone treated group. IL-17 (p=0.001), IL-8 (p=0.001), and IFN-γ (p<0.05) decreased significantly, while TGF-ß had a significant increase (p<0.05). In the patients who delivered before or on the 7th day of admission, IL-17, IL-8, and IFN-γ levels were all significantly higher. However, TGF-ß decreased significantly in the same samples in the betamethasone treated group (p<0.05). CONCLUSION: Betamethasone significantly decreases the endocervical pro-inflammatory cytokine concentrations in patients with preterm labor.
