Placental Villous Expression of TNFa and IL-10 and Effect of Oxygen Tension in Euploid Early Pregnancy Failure

Problem The objective was to investigate placental inflammation in chromosomally normal miscarriages in vivo and in vitro. Method of study Chorionic villous tissue was collected from missed miscarriages and normal gestation-matched controls and cultured at 6 and 20% O2 concentrations. Tissue was karyotyped. Flowcytometric bead arrays and real-time PCR were carried out for protein and gene expression studies. Results The levels of TNF alpha and IL-10 were significantly (P < 0.005 and P < 0.05) higher, and the levels of TNF-R1 and TNF-R2 were significantly (P < 0.01 and P < 0.05) lower in culture conditioned medium of villous explants of miscarriages compared to control group. Villous tissue homogenates from miscarriages contained significantly (P < 0.005) lower levels of TNF-R1. There was a significant O2-dependent increase in the secretion of IL-10 (P < 0.01) and decrease in TNF alpha/IL-10 ratio (P < 0.005) in the culture medium in both groups. Conclusion Increased levels of TNF alpha and decreased levels of receptors in miscarriage villous tissue confirm an excessive placental inflammation in miscarriage patients.