Monocyte Major Histocompatibility Complex Class II... : Obstetrics & Gynecology (original) (raw)
Original Research
Monocyte Major Histocompatibility Complex Class II Expression in Term and Preterm Labor
Lloyd, Jillian MB, ChB, MD1; Allen, Meredith FRACP, PhD2; Azizia, Mallika MBBS1; Klein, Nigel FRCPCH, PhD2; Peebles, Donald MRCOG, MD1
From the 1Institute for Women’s Health, and 2Infectious Diseases and Microbiology Unit, Institute of Child Health, University College London, London, United Kingdom.
Funded by project grant 03UCL01 from SPARKS (Sport Aiding Medical Research for Kids) charity. The study was undertaken at University College London Hospital/University College London, who received a proportion of funding from the Department of Health’s NIHR Biomedical Research Centres funding scheme.
Corresponding author: D. Peebles, Department of O&G, 86–96 Chenies Mews, UCL, London, WC1E 6HX, UK; e-mail: [email protected].
Financial Disclosure The authors have no potential conflicts of interest to disclose.
OBJECTIVE:
To investigate how term and preterm labor (PTL) influence the balance between maternal proinflammatory and antiinflammatory responses as measured by expression of major histocompatibility complex (MHC) Class II on maternal monocytes and tumor necrosis factor-α (TNF-α) production by in vitro stimulation of whole blood by lipopolysaccharide (LPS).
METHODS:
Blood was taken from the following women (n=118): term elective cesarean delivery or in spontaneous labor, in premature labor, or with preterm premature rupture of the membranes (PROM) at less than 32 weeks, and gestation-matched reference group. Monocyte MHC Class II expression was measured by flow cytometry using a dual-staining technique. Plasma cytokine levels were assayed using a cytometric bead array system. In vitro whole blood stimulation with LPS was also performed, and cytokine production was measured.
RESULTS:
Term labor was associated with a fall in the percentage of monocytes expressing MHC Class II, compared with third trimester of pregnancy, P<.05 and a reduction in LPS-stimulated TNF-α production. This fall in MHC Class II was even more pronounced in PTL and preterm PROM groups compared with the reference group, P<.01.
CONCLUSION:
There was evidence of reduced expression of monocyte MHC Class II and LPS-stimulated TNF-α in term and preterm labor. This pattern of reduced MHC Class II expression and reduced TNF-α production is known as monocyte hyporesponsiveness or immune paresis. Detection of this state may provide insights into the maternal inflammatory status and be of use in the management of women with threatened PTL or preterm PROM.
LEVEL OF EVIDENCE:
II
© 2007 by The American College of Obstetricians and Gynecologists. Published by Wolters Kluwer Health, Inc. All rights reserved.