Changes in T-helper associated cytokines and the risk of miscarriage

Objective: to study the cytokine profile features of women in the dynamics of pregnancy complicated by threatened miscarriage during the first trimester. Materials and methods. The analysis of pregnancy and childbirth course of 294 primigravida women was carried out and 72 women whose pregnancy was complicated by threatened miscarriage during the first trimester were enrolled. The control group included 48 somatically healthy pregnant women with a physiological course of pregnancy. Serum cytokines concentrations (interleukin-1 beta (IL-1 beta), interleukin-2 (IL-2), interleukin-4 (IL-4), interleukin-10 (IL-10), gamma-interferon (IFN gamma), tumor necrosis factor-alpha (TNF alpha)) were determined by ELISA using a photometer "Digi Scan-400" (Austria) in the clinical groups of pregnant woman during the first (10-14 weeks), second (23-26 weeks) and third trimesters (32-35 weeks). Results. In women with threatened miscarriage during the first trimester, characteristic changes in the cytokine profile were revealed, which can be divided into 2 groups: the 1st group - changes associated with the functional activity of T-helper type 1(Th1) (decreased IL-1 beta and increased TNF alpha levels during the first trimester; decreased level of TNF alpha during the second trimester); the 2nd group - changes associated with functional activity of T-helper type 2 (Th2) (increased levels of IL-4 and IL-10 during the second trimester of pregnancy). Conclusions. The dynamics of pregnancy complicated by threatened miscarriage during the first trimester involve changes in the character of cytokine profile represented by Th1 cells activation during the first trimester followed by their function depression during the second trimester on the background of increasing production of anti-inflammatory cytokines by Th2 cells. During the third trimester, inflammatory and anti-inflammatory cytokines production is decreased on the background of increased macrophage activity with elevated TNF alpha level in the blood serum of women whose pregnancy was complicated by threatened miscarriage during the first trimester.