The Serum Interleukin-6 and Tumor Necrosis Factor-Α Levels and Their Relationship With Antithrombin-Iii and Von Willebrand Factor in Preeclampsia

Abstract

Objective: Preeclampsia, characterized by changes in the placenta and uteroplacental vasculature, is the most frequent complication of pregnancy. It is argued that an overproduction of placental cytokines may be associated with the pathophysiological changes found in preeclampsia. In this study, it is aimed to determine the levels of both pro-inflammatory (tumor necrosis factor-alpha) and immunoregulatory (interleukin-6) cytokines and their relationships with von Willebrand factor and anti-thrombin III from both preeclamptic and healthy pregnant women. Material and Methods: Twenty-five pregnant women with preeclampsia and 25 healthy pregnant women were included in the study. The fasting blood samples were obtained at eight o'clock in the morning from the both groups and interleukin-6, tumor necrosis factor-alpha, von Willebrand factor and anti-thrombin III levels were measured. From the preeclamptic patients blood samples were obtained at twelve o'clock midnight to determine the diurnal variation in these two cytokine levels. Results: As compared to healthy pregnant group, levels of interleukin-6 and anti-thrombin III were significantly lower and von Willebrand factor level was significantly higher in the preeclamptic group (p< 0.05). Tumor necrosis factor-alpha level did not differ significantly between the two groups. Interleukin-6 and tumor necrosis factor-alpha levels did not show significant diurnal variation in preeclamptic group. A significant positive correlation was found between the tumor necrosis factor-alpha levels measured in the morning and night samples in the preeclamptic group (p< 0.01, r=0.701). Also, a significant positive correlation was found between the tumor necrosis factor-alpha and von Willebrand factor levels in healthy pregnant group (p< 0.05, r=0.648). Conclusions: These findings suggest that preeclampsia is associated with decreased interleukin-6, and anti-thrombin III, and with increased von Willebrand factor levels.