Profile Tumor Necrosis Factor Alpha and Procalcitonin in Preeclampsia and Preeclampsia with Sepsis

Bambang Rahardjo; Tatit  Nurseta; Aqua Rossalinda  Sinaga

doi:10.3889/oamjms.2023.11644

Authors

Bambang Rahardjo Department of Obstetric and Gynecology, Faculty of Medicine, University of Brawijaya, dr. Saiful Anwar Hospital, Malang, Indonesia https://orcid.org/0000-0003-1013-5761
Tatit Nurseta Department of Obstetric and Gynecology, Faculty of Medicine, University of Brawijaya, dr. Saiful Anwar Hospital, Malang, Indonesia
Aqua Rossalinda Sinaga Department of Obstetric and Gynecology, Faculty of Medicine, University of Brawijaya, dr. Saiful Anwar Hospital, Malang, Indonesia

DOI:

https://doi.org/10.3889/oamjms.2023.11644

Keywords:

TNF-α, Procalcitonin, Preeclampsia, Sepsis

Abstract

BACKGROUND: Preeclampsia is hypertension in pregnancy which are characterized by high blood pressure, proteinuria that occur after 20 weeks of GA. Preeclampsia remains a massive cause of maternal morbidity and mortality that 50.000 death annually. The cause of preeclampsia is still unclear but there is a possibility caused by immunological processes in micro placenta environment during the early age of pregnancy. It is suggested that cytokines such as tumor necrosis factor (TNF-α) has an important role in the pathogenesis of preeclampsia. Preeclampsia is an extreme feature of the systemic inflammatory response during pregnancy. Systemic inflammation in preeclampsia can cause organ damage and induce sepsis. The pathophysiology is initiated by a high level of pro-inflammatory cytokine that released by peripheral blood mononuclear cell (PBMC). Beside pro-inflammatory cytokine, the marker of sepsis can be shown by procalcitonin (PCT) that produced by PBMC which is activated by TNF-α.

AIM: The objective of the study is to evaluate profile maternal plasma levels of TNF-α and PCT and analyze their correlation in normotensive pregnant woman, preeclamptic and preeclampsia with sepsis.

METHODS: An observational cross-sectional study. The sample were normotensive, preeclamptic, and preeclamptic with sepsis (n = 18) in Bangil Hospital, Pasuruan. The level of TNF-α and PCT was measured by ELISA. The statistical analysis with SPSS 18.0 with p < 0.05.

RESULTS: This study showed level of TNF-α and PCT in preeclamptic with sepsis was significantly higher than control (p < 0.05) and not a significant difference in preeclampsia (p > 0.05). The level of TNF-α and PCT in preeclampsia compared with control was not a significant difference (p > 0.05). This study showed there was no correlation between TNF-α and PCT in patients with preeclampsia with sepsis.

CONCLUSION: The plasma level of TNF-α and PCT was statistically different between the control group, preeclampsia and preeclampsia with sepsis. There was no significant difference of TNF-α and PCT plasma level in preeclampsia with sepsis than preeclampsia group. There was no significant correlation between preeclampsia in woman and preeclampsia with sepsis in maternal plasma TNF-α and PCT levels.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Gathiram P, Moodley J. Pre-eclampsia: Its pathogenesis and pathophysiolgy. Cardiovasc J Afr. 2016;27(2):71-8. https://doi.org/10.5830/CVJA-2016-009 PMid:27213853 DOI: https://doi.org/10.5830/CVJA-2016-009

Rana S, Lemoine E, Granger JP, Karumanchi SA. Preeclampsia: Pathophysiology, challenges, and perspectives. Circ Res. 2019;124(7):1094-112. https://doi.org/10.1161/circresaha.118.313276 PMid:30920918 DOI: https://doi.org/10.1161/CIRCRESAHA.118.313276

Predoi CG, Grigoriu C, Vladescu R, Mihart AE. Placental damages in preeclampsia-from ultrasound images to histopathological findings. J Med Life. 2015;8:62-5. PMid:26366223

Redman CW, Sargent IL. Immunology of pre-eclampsia. Am J Reprod Immunol. 2010;63(6):534-43. https://doi.org/10.1111/j.1600-0897.2010.00831.x PMid:20331588 DOI: https://doi.org/10.1111/j.1600-0897.2010.00831.x

Saito S, Nakashima A. A review of the mechanism for poor placentation in early-onset preeclampsia: The role of autophagy in trophoblast invasion and vascular remodeling. J Reprod Immunol. 2014;101-2:80-8. https://doi.org/10.1016/j.jri.2013.06.002 PMid:23969229 DOI: https://doi.org/10.1016/j.jri.2013.06.002

Saito S, Sakai M. Th1/Th2 balance in preeclampsia. J Reprod Immunol. 2003;59(2):161-73. https://doi.org/10.1016/s0165-0378(03)00045-7 PMid:12896820 DOI: https://doi.org/10.1016/S0165-0378(03)00045-7

Liu Y, Zhang R, Qu H, Wu J, Li L, Tang Y. Endothelial microparticles activate endothelial cells to facilitate the inflammatory response. Mol Med Rep. 2017;15(3):1291-6. https://doi.org/10.3892/mmr.2017.6113 PMid:28098900 DOI: https://doi.org/10.3892/mmr.2017.6113

Chaudry H, Zhou J, Zong Y, Mustafa Ali M, Mcguire F, Nagarkatti PS, et al. Role of cytokines as a double-edged sword in sepsis. In Vivo. 2013;27(6):669-84. PMid:24292568

Abraham E, Singer M. Mechanisms of sepsis-induced organ dysfunction. Crit Care Med. 2007;35(10):2408-16. https://doi.org/10.1097/01.ccm.0000282072.56245.91 PMid:17948334 DOI: https://doi.org/10.1097/01.CCM.0000282072.56245.91

Ertmer C, Rehberg S. Pathophysiology of sepsis. Dtsch Med Wochenschr. 2016;141(15):1067-73. https://doi.org/10.1055/s-0042-110742 PMid:27464278 DOI: https://doi.org/10.1055/s-0042-110742

Hattori Y, Hattori K, Suzuki T, Matsuda N. Recent advances in the pathophysiology and molecular basis of sepsis- associated organ dysfunction: Novel therapeutic implications and challenges. Pharmacol Ther. 2017;177:56-66. https://doi.org/10.1016/j.pharmthera.2017.02.040 PMid:28232275 DOI: https://doi.org/10.1016/j.pharmthera.2017.02.040

Levy MM, Fink MP, Marshal JC, Abraham E, Angus D, Cook D, et al. 2001 SCCM/ESICM/ACCP/ATS/SIS international sepsis definitions conference. Intensive Care Med. 2003;29(4):530-8. https://doi.org/10.1007/s00134-003-1662-x PMid:12664219 DOI: https://doi.org/10.1007/s00134-003-1662-x

Singer M, Deutschman CS, Seymour CW, Shankar-Hari M, Annane D, Angus DC, et al. The third international consensus definitions for sepsis and septic shock (Sepsis-3). JAMA. 2016;315(8):801-10. https://doi.org/10.1001/jama.2016.0287 PMid:26903338 DOI: https://doi.org/10.1001/jama.2016.0287

Elliot MG. Oxidative stress and the evolutionary origins of preeclampsia. J Reprod Immunol. 2016;114:75-80. https://doi.org/10.1016/j.jri.2016.02.003 PMid:26995772 DOI: https://doi.org/10.1016/j.jri.2016.02.003

Tranquili AL, Dekker G, Magee L, Roberts J, Sibai BM, Steyn W, et al. The classification, diagnosis and management of the hypertensive disorders of pregnancy: A revised statement from the ISSHP. Pregnancy Hypertens. 2014;4(2):97-104. https://doi.org/10.1016/j.preghy.2014.02.001 PMid:26104417 DOI: https://doi.org/10.1016/j.preghy.2014.02.001

Roudsari FV, Ayati S, Ayatollahi H, Esmaeily H, Hasanzadeh M, Shahabian M, et al. Comparison of maternal serum Tumor Necrosis Factor-alpha (TNF-α) in severe and mild preeclampsia versus normal pregnancy. Iran J Reprod Biomed. 2009;7(4):153-6.

Kell DB. Kenny LC. A dormant microbial component in the development of preeclampsia. Front Med (Lausanne).

;3:60. https://doi.org/10.3389/fmed.2016.00060 PMid:27965958 DOI: https://doi.org/10.3389/fmed.2016.00060

Mohajertehran F, Afshari JT, Rezaieyazd Z, Ghomian N. Association of single nucleotide polymorphisms in the human tumor necrosis factor-α and interleukin 1-β genes in patients with pre-eclampsia. Iran J Allergy Asthma Immunol. 2012;11(3):224-9. PMid:22947907

Pinheiro MB, Gomes KB, Ronda CR, Guimaraes GG, Freitas LG, Teixeira-Carvalho A, et al. Severe preeclampsia: Association of genes polymorphisms and maternal cytokines production in Brazilian population. Cytokine. 2015;71(2):232-7. https://doi.org/10.1016/j.cyto.2014.10.021 PMid:25461403 DOI: https://doi.org/10.1016/j.cyto.2014.10.021

Linscheid P, Seboek D, Nylen ES, Langer I, Schlatter M, Becker KL, et al. In vitro and in vivo calcitonin I gene expression in parenchymal cells: A novel product of human adipose tissue. Endocrinology. 2003;144(12):5578-84. https://doi.org/10.1210/en.2003-0854 PMid:12960010 DOI: https://doi.org/10.1210/en.2003-0854

Meisner M. Update on procalcitonin measurements. Ann Lab Med. 2014;34(4):263-73. https://doi.org/10.3343/alm.2014.34.4.263 PMid:24982830 DOI: https://doi.org/10.3343/alm.2014.34.4.263

Shaikh MM, Hermans LE, van Laar JM. Is serum procalcitonin measurement a useful addition to a rheumatologist’s repertoire? A review of its diagnostic role in systemic inflammatory diseases and joint infections. Rheumatology (Oxford). 2015;54(2):231-40. https://doi.org/10.1093/rheumatology/keu416 PMid:25349443 DOI: https://doi.org/10.1093/rheumatology/keu416

Fu Y, Chen Y, Bai N, Liu R, Li D. Correlation of TNF-α gene polymorphisms with sepsis susceptibility. Int J Clin Exp Pathol. 2016;9(2):2335-9.