Analysis of monocyte subsets and toll-like receptor 4 expression in peripheral blood monocytes of women in preterm labor

Preterm labor is associated with both localized inflammation of the uterus and elevated proinflammatory cytokines. Recently, specific roles have been suggested for distinct monocyte subsets and toll-like receptor 4 (TLR4) expression in inflammation. The aim of this study was to determine whether specific monocyte subsets and increased TLR4 expression in monocyte subsets contribute to preterm labor. The study included 30 preterm labor, 40 full-term labor and 20 pregnant women (not in labor). Four-color flow cytometry was used to examine the distribution of three monocyte subsets (CD14(+)CD16(-), CD14(high)CD16(+), and CD14(low)CD16(+)) and the TLR4 expression in each monocyte subset in each group of women. A larger percentage of CD14(high)CD16(+) cells was found in the preterm labor group than in the other groups (P = 0.08, P = 0.06). Women in preterm labor also showed significantly higher TLR4 expression in all monocyte subsets and increased fluorescence intensity in the CD14(+)CD16(-) and CD14(high)CD16(+) cells. Expression of TLR4 and mean fluorescence intensity on each monocyte subset were also significantly correlated. We conclude that women with preterm labor have higher CD16 monocytes, with high concomitant expression of CD14 and enhanced TLR4 expression in monocytes, and that monocyte TLR4 levels could be used as a marker to predict preterm delivery. (c) 2012 Elsevier Ireland Ltd. All rights reserved.