Serum cytokine levels and T lymphocyte subsets in pregnant women with eclampsia


Background: Eclampsia, defined as the occurrence during pregnancy of hypertension, oedema, proteinuria and/or other neurologic abnormalities, causes substantial morbidity and mortality for both mother and foetus. However, its aetiology is largely unknown. Genetic and immune factors may play a role including a reduced maternal response to paternal antigen and an altered adaptation of the maternal immune system to the foetus. Methods: Participants consisted of pregnant women with and without a diagnosis of eclampsia (N = 20, each group), and normal healthy nonpregnant controls (N = 18). Women with smear positive malaria or clinical infections were excluded. Serum levels of TNFα and IL-10 were assayed by ELISA. T lymphocyte subsets of pregnant patients with and without eclampsia were also studied by direct immunofluorescence using monoclonal antibodies and compared with the control group of 18 normal healthy nonpregnant women (NHC). Results: Eclampsia was associated with significantly lower mean serum IL-10 levels compared to normal pregnant and nonpregnant controls. Levels of the pro-inflammatory cytokine TNFα were higher in pregnant women with and without eclampsia, compared to control nonpregnant women. Further differences on serum cytokine levels were observed in the significantly increasing ratio of IL-10 to TNFα from nonpregnant controls to normal pregnant women and to pregnant women with eclampsia. The mean values of CD3+ and CD4+ positive lymphocytes was significantly decreased in patients with eclampsia (p < 0.05) in this study compared to pregnant controls. Similarly, CD3+ and CD4+ T cells were further decreased in eclampsia and pregnant controls compared to nonpregnant controls (p < 0.05). A decreasing CD4/CD8 ratio was observed from non-pregnant to pregnant controls and to patients with eclampsia buttressing an increase in CD8+ cells in eclampsia and pregnancy compared to controls. Conclusions: While a pro-inflammatory immune milieu during pregnancy complicated with eclampsia was demonstrated, the presence of eclampsia was not associated with further cytokine differences.

Share and Cite:

Musa, B. , Onyemelukwe, G. , Olatunji, O. , Odogwu, K. , Hambolu, J. and Kene, T. (2012) Serum cytokine levels and T lymphocyte subsets in pregnant women with eclampsia. Open Journal of Immunology, 2, 116-124. doi: 10.4236/oji.2012.23014.

Conflicts of Interest

The authors declare no conflicts of interest.


[1] Acquaah-Arhin, R. and Kwawukume, E.Y. (2003) Trends in Eclampsia at Korle-Bu Teaching hospital, Accra, Ghana. Nigerian Journal of Clinical Practice, 6, 1-4.
[2] Konje, J.C., Obisesan, K.A., Odukoya, K.A. and Ladipo, O.A. (1992) Presentation and management of eclampsia. International Journal of Gynecology & Obstetrics, 38, 31-35. doi:10.1016/0020-7292(92)90726-Y
[3] Colli, E., Bertulessi, C., Landon, M. and Parrazzini, F. (1996) Bacterial vaginosis in pregnancy and preterm birth: Evidence from literature. The Journal of International Medical Research, 24, 317-324.
[4] Ekwempu, C.C. (1980) Infection as a possible trigger factor in the genesis of eclampsia. Tropical Doctor, 10, 174-178.
[5] Sargent, H., Redman, C.W.G. and Stirrat, G.M. (1982) Maternal cell mediated immunity in normal and preeclamptic pregnancy. Clinical & Experimental Immunology, 50, 601-609.
[6] Coggon, D, Rose, G. and Barker, D.J.P. (2002) Epidemiology for the uninitiated. 4th Edition, Churchill-Living-stone, Edingburgh, 22.
[7] Sibai, B.M. (1996) Drug therapy: Treatment of hypertension in pregnant women. New England Journal of Medicine, 335, 1-10.
[8] Anim-Nyame, N., Sooranna, S.R., Jones, J., Alaghband, Zadeh, J., Steer, P.J. and Johnson, M.R. (2001) Biochemical markers of bone turnover are elevated in pre-eclampsia. British Journal of Obstetrics and Gynaecology, 108, 258-262. doi:10.1111/j.1471-0528.2001.00068.x
[9] Tietz, N.W. (2001) Clinical chemistry in laboratory tests. WB Sanders, London.
[10] Dacie, J.V. and Lewis, S.M. (1991) Practical haematology. 7th Edition, Churchill Livingstone, Edinburgh, 54-79.
[11] Pathare, A, Al Kindi, S, Alnaqdy, A, Daar, S, Knox-Macauly, H. and Dennison, D. (2004) Cytokine profile of sickle cell disease in Oman. American Journal of Hematology, 77, 323-328. doi:10.1002/ajh.20196
[12] Musa, B.O.P., Onyemelukwe, G.C., Hambolu, J.O., Mamman, A.I. and Isah, A.I. (2010) Pattern of serum cytokine expression and T cell subsets in sickle cell disease patients in vaso-occlusive crisis. Clinical and Vaccine Immunology, 17, 602-608. doi:10.1128/CVI.00145-09
[13] Gupta, S. and Good, R.A. (1989) Subpopulations of human lymphocytes.1. Studies in immunodeficient patients. Clinical & Experimental Immunology, 30, 222.
[14] Jonsson Y., Ruber, M., Matthiesen, L., Berg, G., Nieminem, K., Sharma, S., Ernerudh, J. and Ekerfelt, C. (2006) Cytokine mapping of sera from women with preeclampsia and normal pregnancies. Journal of Reproductive Immunology, 70, 83-91. doi:10.1016/j.jri.2005.10.007
[15] Chen, Q., Wahlgren, M. and Schlichtherle, M. (2000) Molecular aspects of severe malaria. Clinical Microbiology Reviews, 13, 439-450. doi:10.1128/CMR.13.3.439-450.2000
[16] Pearce, J.E. and Tarleton, R.L. (2002) Overview of the parasitic pathogens. In: Kaufmann, S.H.E., Sher, A. and Ahmed, R., Eds., Immunology of Infectious Diseases, ASM Press, Washington DC, 39-52.
[17] Kaufmann, S.H.E., Sher, A. and Ahmed, R (Eds.) (2002) Immunology of infectious diseases. ASM Press, Washington DC, 39-52.
[18] Kupfermine, M.J, Peaceman, A.M, Aderka, D, Wallach, D. and Socol, M.L. (1996) Soluble tumor necrosis factor receptors in women with pre-eclampsia. Obstetrics & Gynaecology, 88, 420-427. doi:10.1016/0029-7844(96)00179-2
[19] Teran, E., Escudero, C., Moya, W., Flores, M., Vallance, P. and Lopez-Jaramillo, P. (2001) Elevated C-reactive protein and pro-inflammatory cytokines in Andean women with Pre-eclampsia. International Journal of Gynecology & Obstetrics, 75, 243-249. doi:10.1016/S0020-7292(01)00499-4
[20] Ng, P.C., Li, K., Wong, R.P.O., Chiu, K., Wong, E., Li, G. and Fok, T.F. (2003) Pro-inflammatory cytokine responses in preterm infants with systemic infections. Archives of Disease in Childhood. Fetal and Neonatal Edition, 88, F209-213.
[21] Hill, J.A., Polgar, K. and Anderson, D.J. (1995) T helper 1-type immunity to trophoblast in women with recurrent spontaneous abortion. Journal of the American Medical Association (JAMA), 273, 1933-1936. doi:10.1001/jama.1995.03520480053039
[22] Hanna, N, Hanna, J, Hleb, M, Wagner, E, Dougherty, J, Balkindi, D, Padbury, J. and Sharma, S. (2000) Gestational age dependent expression of IL-10 and its receptor in human placental tissues and isolated cytotrophoblasts. Journal of Immunology, 164, 5721-5728.
[23] Srivastava, M.D., Lippes, J. and Srivastava, B.I. (1996) Cytokines of the human reproductive tract. American Journal of Reproductive Immunology, 36, 157-166. doi:10.1111/j.1600-0897.1996.tb00157.x
[24] Roitt, I, Brostoff, J. and Male, D. (2001) Immunology. Edinburgh Harcourt Publishers Ltd., 126.
[25] Tallon, D.F, Darach Corcoran, D.J, O’Dwyer, E.M. and Greally, J.F. (1984) Circulating lymphocyte subpopulations in pregnancy: A longitudinal study. The Journal of Immunology, 132, 1784-1787.
[26] Rajvanshi, V.S., Capoor, U., Shanker, R. and Upreti, S. (1981) Lymphocyte subpopulations in normal human pregnancy. Indian Journal of Medical Research, 73, 519-526.
[27] Gusdon, J.P., Heise, E. R. and Herbst, G.A. (1977) Studies of lymphocyte populations in pre-eclampsia-eclampsia. American Journal of Obstetrics and Gynecology, 129, 255-2557.
[28] Birkeland, S.A. and Kristofferson, K. (1979) Pre-eclampsia—A state of mother-fetus immune imbalance. Lancet, 2, 720-725. doi:10.1016/S0140-6736(79)90645-7
[29] Sridama, V., Pacini, F., Yang, S.L., Moawad, A., Reilly, M. and DeGroot, L.J. (1982) Decreased levels of helper T cells—A possible cause for immunodeficiency in pregnancy. New England Journal of Medicine, 307, 352. doi:10.1056/NEJM198208053070606
[30] Hotchkiss, R.S. and Karl, I.E. (2003) The pathophysiology and treatment of sepsis. New England Journal of Medicine, 348, 2. doi:10.1056/NEJMra021333
[31] Devlin, J.G. (1975) Hormone resistance and hypersensitivity. In: Gell, P.G.H., Coombs, R.R.A. and Lachman, P.J., Eds., Clinical aspects of Immunology, 3rd Edition, Blackwell Publn, 963-980.
[32] Jenkins, D.M. (1977) Immunological aspects of the pathogenesis of pregnancy hypertension. Clinical Obstetrics and Gynecology, 4, 665-684.
[33] Carr, M.C., Stites, D.P. and Fudenberg, H.H. (1973) Cellular immune aspects of the human fetal-maternal relationship II. In vitro response of gravida lymphocytes to phytohaemagglutinin. Cellular Immunology, 8, 448. doi:10.1016/0008-8749(73)90136-6
[34] Pier, G.B., Lyczak, J.B. and Wetzler, L.M. (2004) Immunology, infection and immunity. ASM Press, Washington DC, 315-342.

Copyright © 2023 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.