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Wu J, Cao Q, Liao J, Li Y, Lu G, Gong F, Lin G, Zhao M. Immunological Indicators of Recurrent Pregnancy Loss: A Mendelian Randomization Study. Reprod Sci 2024:10.1007/s43032-024-01555-2. [PMID: 38658490 DOI: 10.1007/s43032-024-01555-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2023] [Accepted: 04/02/2024] [Indexed: 04/26/2024]
Abstract
Recurrent pregnancy loss (RPL) is thought to be related to maternal-fetal immune tolerance disorders. Immune monitoring of RPL patients mainly involves two aspects: inflammatory factors and immune cells. However, most observational studies have reported controversial findings. This study aimed to confirm whether abnormal inflammatory factors and immune cells in peripheral blood may lead to RPL, and guide clinical immune monitoring. We demonstrated causality using two-sample Mendelian randomization. Sensitivity analysis, reverse Mendelian randomization and meta-analysis were used to enhance the effectiveness of the results. There was a causal relationship between the level of IL-12 (OR = 1.78, 95% CI = 1.25-2.55; P = 0.00149) and RPL for 41 inflammatory factors. We screened 5 groups of immune cell subtypes that were causally associated with RPL: switched memory B-cell absolute count (OR = 0.66, 95% CI = 0.49-0.87, P = 0.00406), IgD + CD24 + B-cell absolute count (OR = 0.69, 95% CI = 0.53-0.88, P = 0.00319), CD39 + resting CD4 regulatory T-cell %CD4 regulatory T-cell (OR = 0.86, 95% CI = 0.78-0.95, P = 0.00252), activated & resting CD4 regulatory T-cell %CD4 regulatory T-cell (OR = 0.89, 95% CI = 0.82-0.97, P = 0.00938) and CD45 RA + CD28-CD8 + T-cell %CD8 + T-cell (OR = 0.99, 95% CI = 0.98-1.00, P = 0.01231). In terms of inflammatory factors, a causal relationship between IL-12 and RPL in peripheral blood was confirmed. We also identified five immune cell phenotypes that play a protective role. This suggests that there may be protective B cells and CD8 + T-cell subsets in peripheral blood, and the protective effect of Tregs was proved again. Immune monitoring of peripheral blood in patients with RPL seems to be necessary and the foundation for precision medicine.
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Affiliation(s)
- Jingrouzi Wu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, 410078, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China
| | - Qingtai Cao
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, 410078, China
| | - Jingnan Liao
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, 410078, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China
| | - Yuan Li
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China
| | - Guangxiu Lu
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, 410078, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China
| | - Fei Gong
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, 410078, China
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China
| | - Ge Lin
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, 410078, China.
- Reproductive and Genetic Hospital of CITIC-Xiangya, Changsha, 410078, China.
| | - Mingyi Zhao
- Institute of Reproductive and Stem Cell Engineering, School of Basic Medical Science, Pediatric Department of the 3rd Xiangya Hospital, Central South University, Changsha, 410078, China.
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The Update Immune-Regulatory Role of Pro- and Anti-Inflammatory Cytokines in Recurrent Pregnancy Losses. Int J Mol Sci 2022; 24:ijms24010132. [PMID: 36613575 PMCID: PMC9820098 DOI: 10.3390/ijms24010132] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 12/12/2022] [Accepted: 12/15/2022] [Indexed: 12/24/2022] Open
Abstract
Recurrent pregnancy losses (RPL) is a common reproductive disorder with various underlying etiologies. In recent years, rapid progress has been made in exploring the immunological mechanisms for RPL. A propensity toward Th2 over Th1 and regulatory T (Treg) over Th17 immune responses may be advantageous for reproductive success. In women with RPL and animals prone to abortion, an inordinate expression of cytokines associated with implantation and early embryo development is present in the endometrium or decidua secreted from immune and non-immune cells. Hence, an adverse cytokine milieu at the maternal-fetal interface assaults immunological tolerance, leading to fetal rejection. Similar to T cells, NK cells can be categorized based on the characteristics of cytokines they secrete. Decidual NK (dNK) cells of RPL patients exhibited an increased NK1/NK2 ratio (IFN-γ/IL-4 producing NK cell ratios), leading to pro-inflammatory cytokine milieu and increased NK cell cytotoxicity. Genetic polymorphism may be the underlying etiologies for Th1 and Th17 propensity since it alters cytokine production. In addition, various hormones participate in cytokine regulations, including progesterone and estrogen, controlling cytokine balance in favor of the Th2 type. Consequently, the intricate regulation of cytokines and hormones may prevent the RPL of immune etiologies. Local or systemic administration of cytokines or their antagonists might help maintain adequate cytokine milieu, favoring Th2 over Th1 response or Treg over Th17 immune response in women with RPL. Herein, we provided an updated comprehensive review regarding the immune-regulatory role of pro- and anti-inflammatory cytokines in RPL. Understanding the roles of cytokines involved in RPL might significantly advance the early diagnosis, monitoring, and treatment of RPL.
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Graham JJ, Longhi MS, Heneghan MA. T helper cell immunity in pregnancy and influence on autoimmune disease progression. J Autoimmun 2021; 121:102651. [PMID: 34020252 PMCID: PMC8221281 DOI: 10.1016/j.jaut.2021.102651] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2021] [Revised: 04/30/2021] [Accepted: 05/02/2021] [Indexed: 02/07/2023]
Abstract
Pregnancy presents the maternal immune system with a unique immunological challenge since it has to defend against pathogens while tolerating paternal allo-antigens expressed by fetal tissues. T helper (Th) cells play a central role in modulating immune responses and recent advances have defined distinct contributions of various Th cell subsets throughout each phase of human pregnancy, while dysregulation in Th responses show association with multiple obstetrical complications. In addition to localized decidual mechanisms, modulation of Th cell immunity during gestation is mediated largely by oscillations in sex hormone concentrations. Aberrant Th cell responses also underlie several autoimmune disorders while pregnancy-induced changes in the balance of Th cell immunity has been shown to exert favorable outcomes in the progression Th1 and Th17 driven autoimmune conditions only to be followed by post-partal exacerbations in disease.
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Affiliation(s)
- Jonathon J Graham
- Institute of Liver Studies, King's College Hospital, London, SE5 9RS, United Kingdom
| | - Maria Serena Longhi
- Department of Anesthesia, Critical Care & Pain Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Avenue, Boston, MA, 02215, USA
| | - Michael A Heneghan
- Institute of Liver Studies, King's College Hospital, London, SE5 9RS, United Kingdom.
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Salimi E, Karimi-Zarchi M, Dastgheib SA, Abbasi H, Tabatabaiee RS, Hadadan A, Amjadi N, Akbarian-Bafghi MJ, Neamatzadeh H. Association of Promoter Region Polymorphisms of IL-6 and IL-18 Genes with Risk of Recurrent Pregnancy Loss: A Systematic Review and Meta-Analysis. Fetal Pediatr Pathol 2020; 39:346-359. [PMID: 31437073 DOI: 10.1080/15513815.2019.1652379] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Abstract
Background: The present meta-analysis was performed to investigate the association of promoter region polymorphisms at IL-6 and IL-18 genes with recurrent pregnancy loss (RPL) risk. Methods: An electronic search of the PubMed, Embase, ISI Web of Knowledge and CNKI databases was performed to identify eligible studies up to May 30, 2019. Results: A total of 31 case-control studies were finally selected. Significant associations with the risk of RPL were detected for the IL-6 -174 G > C, -634 G > C and IL-18 -137 G > C polymorphisms in overall population. Further, subgroup analyses by ethnicity revealed that the IL-6 -174 G > C and -634 G > C polymorphisms were significantly associated with risk of RPL risk in Asians. Conclusions: Our results suggest that the IL-6 -174 G > C, -634 G > C and IL-18 -137 G > C polymorphisms may contribute to the susceptibility of RPL. The IL-18 -607 C > A polymorphism does not appear to influence the development of RPL.
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Affiliation(s)
- Erfaneh Salimi
- Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Mojgan Karimi-Zarchi
- Department of Gynecology and Obstetrics, Iran University of Medical Sciences, Tehran, Iran
| | | | - Hajar Abbasi
- Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Razieh Sadat Tabatabaiee
- Department of Gynecology and Obstetrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Amaneh Hadadan
- Department of Gynecology and Obstetrics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
| | - Nooshin Amjadi
- Department of Gynecology and Obstetrics, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | - Hossein Neamatzadeh
- Department of Medical Genetics, Shahid Sadoughi University of Medical Sciences, Yazd, Iran
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Soheilyfar S, Nikyar T, Fathi Maroufi N, Mohebi Chamkhorami F, Amini Z, Ahmadi M, Haj Azimian S, Isazadeh A, Taefehshokr S, Taefehshokr N. Association of IL-10, IL-18, and IL-33 genetic polymorphisms with recurrent pregnancy loss risk in Iranian women. Gynecol Endocrinol 2019; 35:342-345. [PMID: 30526181 DOI: 10.1080/09513590.2018.1528220] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
Recurrent pregnancy loss (RPL) is a heterogeneous disease with three or more consecutive abortions before 20 weeks of pregnancy. Recently, inflammatory factors such as interleukins (IL) have been found to be a significant factor in the RPL. The objective of this study was to investigate the association between RPL and IL-10 (rs1800896), IL-18 (rs1946518) and IL-33 (rs1929992) genes polymorphisms in Iranian women. The study participants consisted of 300 women with RPL and the control group comprised of 300 healthy women with successful delivery. Genomic DNA was extracted from peripheral blood, and genotyping was performed by polymerase chain reaction (PCR) followed by restriction fragment length polymorphism (RFLP). There were no significant differences in the frequencies of genotype and allele in IL-10 gene polymorphism (rs1800896) between patients and control group (p > .005). In contrast, there were significant differences in the frequencies of CC genotype in IL-18 gene polymorphism (rs1946518) between patients and the control groups (p = .004; OR =0.990; 95% CI: 0.320-8.855). Also, there were significant differences in the frequencies of GA genotype in IL-33 gene polymorphism (rs1929992) between patients and the control groups (p = .001; OR =0.955; 95% CI: 0.239-9.807). Present study showed that the rs1800896 polymorphism (IL-10) might not play role in RPL in the Iranian population; whereas rs1946518 (IL-18) and rs1929992 (IL-33) polymorphisms may be associated with the risk of RPL in the Iranian women.
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Affiliation(s)
- Sorour Soheilyfar
- a Department of Genetic , Ashkezar Branch, Islamic Azad University , Ashkezar , Iran
| | - Tahereh Nikyar
- b Department of Physiology, Faculty of Medicine , Mashhad University of Medical Sciences , Mashhad , Iran
| | - Nazila Fathi Maroufi
- c Department of Clinical Biochemistry and Laboratory Medicine , Tabriz University of Medical Sciences , Tabriz , Iran
- d Student Research Committee , Tabriz University of Medical Sciences , Tabriz , Iran
| | | | - Zahra Amini
- f Department of Marine Biology , Khorramshahr Marine Science and Technology University , Khorramshahr , Iran
| | - Mahsa Ahmadi
- g Department Cellular and Development , Karaj Branch, Islamic Azad University , Karaj , Iran
| | - Saba Haj Azimian
- h Department of Genetic, Tabriz Branch , Islamic Azad University , Tabriz , Iran
| | - Alireza Isazadeh
- h Department of Genetic, Tabriz Branch , Islamic Azad University , Tabriz , Iran
- i Young Researchers and Elite Club, Maragheh Branch , Islamic Azad University , Maragheh , Iran
| | - Sina Taefehshokr
- j Department of Veterinary Medicine, Tabriz Branch , Islamic Azad University , Tabriz , Iran
| | - Nima Taefehshokr
- k Division of Biosciences, Department of Life Sciences, College of Health and Life Sciences , Brunel University London , Uxbridge , United Kingdom
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Targeted drugs in spondyloarthritis during pregnancy and lactation. Pharmacol Res 2018; 136:21-28. [PMID: 30125669 DOI: 10.1016/j.phrs.2018.08.009] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 07/29/2018] [Accepted: 08/13/2018] [Indexed: 12/16/2022]
Abstract
Spondyloarthritis (SpA) are a heterogeneous group of chronic inflammatory joint diseases that includes several clinical subgroups. SpA can affect women in the reproductive stage so pregnancy can influence the course of the disease and SpA can affect the maternal-fetal outcome. The treatment of SpA has changed dramatically in recent years and the use of targeted drugs is part of therapeutic armamentarium. The use of targeted drugs during pregnancy is controversial because the information available on safety during this period is still limited. Several cytokines have an important role in the normal development of pregnancy or other cytokines may play a role in certain maternal-fetal complications. Potentially targeted drugs can affect the function of these cytokines during pregnancy. The aim of this study is to review the interrelationship between SpA during pregnancy and lactation, the role of some cytokines during normal pregnancy and the development of maternal-fetal complications as well as to review recent information on targeted drugs during pregnancy and breastfeeding in these patients in order to maximize their use in these critical periods of life.
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Wang F, Zhu H, Li B, Liu M, Liu D, Deng M, Wang Y, Xia X, Jiang Q, Chen D. Effects of human chorionic gonadotropin, estradiol, and progesterone on interleukin-18 expression in human decidual tissues. Gynecol Endocrinol 2017; 33:265-269. [PMID: 28277142 DOI: 10.1080/09513590.2016.1212829] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Interleukin (IL)-18 is a proinflammatory cytokine which mediates a myriad of inflammatory responses during pregnancy. Changes in IL-18 levels have been linked to complications during pregnancy. This study was designed to assess the effects of estradiol, human chorionic gonadotropin (hCG), and progesterone on IL-18 expression in human decidual tissues. Uterine deciduas from women with normal pregnancy, spontaneous abortion, and progesterone treated spontaneous abortion were collected, and the effects of hormones on the viability of decidual cells and IL-18 secretion were detected by MTT and ELISA assays. We found that Estradiol, hCG, and progesterone inhibited decidual cell growth independent of dosage and time.IL-18 secretion in the spontaneous abortion group was increased in the decidual cells over time, but all hormones significantly reduced its secretion (p < 0.05). Our results indicate that estradiol, hCG, and progesterone can reduce IL-18 secretion in the cultured endometrial stromal cells from patients who experienced spontaneous abortion to the levels observed following normal pregnancy. Progesterone can significantly reduce IL-18 expression and increase growth of CD56+ CD16- uNK cells, suggesting that these activities may underlie the mechanism by which progesterone improves pregnancy outcomes.
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Affiliation(s)
- Fang Wang
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
| | - Hong Zhu
- b Department of Obstetrics and Gynecology , The People's Hospital of Jiangmen , Guangdong , China , and
| | - Bing Li
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
| | - Mingxing Liu
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
| | - Dan Liu
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
| | - Meilian Deng
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
| | - Yanming Wang
- c Department of Gynecology & Obstetrics , Affiliated Hospital of Yan'an University , Yan'an , China
| | - Xuefeng Xia
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
| | - Qingping Jiang
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
| | - Dunjin Chen
- a Key Laboratory of Major Obstetrics Diseases of Guangdong Province, The Third Affiliated Hospital of Guangzhou Medical University , Guangdong , China
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Zhang M, Xu J, Bao X, Niu W, Wang L, Du L, Zhang N, Sun Y. Association between Genetic Polymorphisms in Interleukin Genes and Recurrent Pregnancy Loss - A Systematic Review and Meta-Analysis. PLoS One 2017; 12:e0169891. [PMID: 28103273 PMCID: PMC5245830 DOI: 10.1371/journal.pone.0169891] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2016] [Accepted: 12/22/2016] [Indexed: 11/19/2022] Open
Abstract
Interleukins are a group of immunomodulatory proteins that mediate a variety of immune reactions in the human body. To investigate the association between interleukin gene polymorphisms and recurrent pregnancy loss (RPL), we reviewed 21 studies from MEDLINE, EMBASE, OVID SP and PubMed to evaluate RPL-related interleukin gene polymorphisms. Meta-analysis was performed on 12 of the polymorphisms, and a review included the others. Our integrated results indicated that IL-1β (-511C/T) (P = 0.02, 95% CI 0.77[0.62,0.96]), IL-6 (-634C/G) (P<0.001, 95% CI 2.91[2.01,4.22]), IL-10 (-1082G/A, -819T/C) (P = 0.01, 95% CI 0.80[0.67,0.96]; P<0.01, 95% CI 0.66[0.49,0.89]), and IL-18 (-137G/C, -105G/A) (P<0.01, 95% CI 1.69[1.24,2.31]; P = <0.01, 95% CI 1.41[1.17,1.70]) consistently associated with RPL after meta-analysis. IL-17A rs2275913 and IL-17F rs763780, IL-21 rs2055979 and rs13143866, IL-1β (-31C/T), IL-6 (-2954G/C), and IL-10 (-536A/G) were reported only once as having a significant association with RPL. The potential mechanism underlying miscarriage and these polymorphisms and future research directions are also discussed.
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Affiliation(s)
- Meixiang Zhang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Jiawei Xu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Xiao Bao
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Wenbin Niu
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Linlin Wang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Linqing Du
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Nan Zhang
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
| | - Yingpu Sun
- Center for Reproductive Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, People’s Republic of China
- * E-mail:
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Chen H, Yang X, Du J, Lu M. Interleukin-18 gene polymorphisms and risk of recurrent pregnancy loss: A systematic review and meta-analysis. J Obstet Gynaecol Res 2015; 41:1506-13. [PMID: 26346467 DOI: 10.1111/jog.12800] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2015] [Accepted: 06/09/2015] [Indexed: 11/28/2022]
Abstract
Interleukin-18 (IL-18) plays a potential pathological role in recurrent pregnancy loss (RPL). The results of published studies on the relationship between IL-18 gene promoter polymorphisms (-137G/C and-607C/A) and RPL risk remain controversial. This meta-analysis was performed to evaluate the association of IL-18, -137G/C and-607C/A gene polymorphisms with the risk of RPL under recessive, dominant and additive genetic models. A literature search was conducted in Medline, Embase and Web of Science for studies that described the effect of IL-18 gene polymorphisms on RPL risk. The numbers of each -137G/C and-607C/A genotype in the case and control groups were extracted. Quality of the original studies' methodology was also assessed. Meta-analysis was performed using Stata 13.1 software and the fixed effect model was used. Five articles were included in this meta-analysis. No significant heterogeneity between the studies was noted. The IL-18 -137 G/C polymorphism was significantly associated with an increased risk of RPL under a recessive genetic model (CC vs. GG + CG: odds ratio = 1.56, 95% confidence interval = 1.13 ~ 2.15). For the -607C/A mutation, we failed to find any association under any genetic models. The Egger's regression asymmetry test showed no publication bias. Our present study indicates a positive association between the CC genotype of the IL-18 -137G/C gene and RPL risk. Future well-designed large studies are needed to validate the association between IL-18 gene polymorphisms and the risk of RPL.
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Affiliation(s)
- Hui Chen
- Clinical Epidemiology Unit, Qilu Hospital, Shandong University, Jinan, China.,Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Xiaorong Yang
- Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Jinge Du
- Clinical Epidemiology Unit, Qilu Hospital, Shandong University, Jinan, China.,Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
| | - Ming Lu
- Clinical Epidemiology Unit, Qilu Hospital, Shandong University, Jinan, China.,Department of Epidemiology, School of Public Health, Shandong University, Jinan, China
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Yue J, Tong Y, Zhou J, Liu Q, Yang J. Genetic variant in interleukin-18 is associated with idiopathic recurrent miscarriage in Chinese Han population. Int J Mol Sci 2015; 16:4180-9. [PMID: 25690033 PMCID: PMC4346951 DOI: 10.3390/ijms16024180] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2014] [Revised: 01/23/2015] [Accepted: 02/10/2015] [Indexed: 02/05/2023] Open
Abstract
Levels of IL-18 were significantly lower in women with recurrent miscarriage (RM) than those without idiopathic RM. IL-18 promoter single nucleotide polymorphisms were previously identified to have an impact on IL18 gene transcription activity and influence the level of IL-18 protein production. The aim of this study was to evaluate whether IL-18 gene polymorphisms are risk factors for idiopathic RM in Chinese Han population. Study subjects comprised of 484 idiopathic RM patients and 468 controls. Three polymorphisms (rs360717, rs187238, rs1946518) in IL-18 gene and serum IL-18 concentrations were assessed. rs187238 variant exhibits significant association with RM in additive and recessive genetic model (additive model p = 1.05 × 10−4, dominant model p = 0.025, recessive model p = 2.43 × 10−5). In contrast, rs360717 and rs1946518 are not significantly associated with RM. Serum IL-18 levels are significantly lower in RM cases than in control (111.98 ± 93.13 versus 148.74 ± 130.51 pg/mL, p = 7.42 × 10−7). There are lower levels of serum IL-18 in rs187238 homozygous mutant (CC) than homozygous wild-type (GG) in this study population, including cases and control groups (98.31 ± 86.46 versus 131.87 ± 115.02 pg/mL, p = 0.015). These results suggest that reduced IL-18 levels and rs187238 variant may contribute to pathogenesis of idiopathic RM in Chinese Han population.
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Affiliation(s)
- Jun Yue
- Department of Gynecology & Obstetrics, Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, No. 32, Section 2, the Western First Round Road, Chengdu 610072, China.
| | - Yu Tong
- Laboratory of Early Developmental and Injuries, West China Institute of Woman and Children's Health, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu 610072, China.
- Key Laboratory of Gynecologic & Obstetric and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610072, China.
| | - Jing Zhou
- Department of Laboratory Medicines, West China Hospital, Sichuan University, No. 37, Guo Xue Xiang, Chengdu 610072, China.
| | - Qingqing Liu
- Laboratory of Early Developmental and Injuries, West China Institute of Woman and Children's Health, West China Second University Hospital, Sichuan University, No. 20, Section 3, Renmin Nanlu, Chengdu 610072, China.
- Key Laboratory of Gynecologic & Obstetric and Pediatric Diseases and Birth Defects of Ministry of Education, Chengdu 610072, China.
| | - Jiyun Yang
- Sichuan Provincial Key Laboratory for Human Disease Gene Study, Hospital of the University of Electronic Science and Technology of China and Sichuan Provincial People's Hospital, No. 32, Section 2, the Western First Round Road, Chengdu 610072, China.
- School of Medicine, University of Electronic Science and Technology of China, No. 32, Section 2, the Western First Round Road, Chengdu 610072, China.
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Si LF, Zhang SY, Gao CS, Chen SL, Zhao J, Cheng XC. Effects of IFN-γ on IL-18 Expression in Pregnant Rats and Pregnancy Outcomes. ASIAN-AUSTRALASIAN JOURNAL OF ANIMAL SCIENCES 2014; 26:1399-405. [PMID: 25049723 PMCID: PMC4093076 DOI: 10.5713/ajas.2013.13101] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/12/2013] [Revised: 07/10/2013] [Accepted: 05/29/2013] [Indexed: 01/12/2023]
Abstract
The present study focused on establishing the effects of interferon-gamma (IFN-γ) on interleukin-18 (IL-18) expression patterns and pregnancy outcomes in pregnant rats. Pregnant rats at the post-implantation stage were randomized into control, low IFN-γ (L-IFN-γ) and high IFN-γ groups (H-IFN-γ) that received normal saline, 100 IU/g of IFN-γ and 500 IU/g of IFN-γ vaginal muscular injection, respectively. The effects of IFN-γ on IL-18 expression and pregnancy outcomes were assessed systematically using several methods, including immunohistochemistry streptavidin-perosidase (SP), image pattern analysis, enzyme-linked immune-sorbent assay (ELISA), whole blood count (WBC) count, microscopy and visual observation. IL-18 was detected in the uteri of all pregnant rats, and mainly distributed in the endometrium, decidual cells, vascular endothelium and myometrium. Immunohistochemistry and image pattern analyses revealed significantly lower IL-18 expression in the H-IFN-γ group compared to the L-IFN-γ and control groups (p<0.01), indicating that high doses of IFN-γ induce downregulation of IL-18 in the uterus of pregnant rats. ELISA results disclosed that IL-18 expression in peripheral blood of the H-IFN-γ group was lower than that of the L-IFN-γ group (p<0.05), and significantly reduced compared to the control group (p<0.01). Moreover, the number of peripheral leukocytes in the H-IFN-γ group was significantly higher than those in the control and L-IFN-γ groups (p<0.01). Morphology analysis showed no evident differences between the L-IFN-γ and control groups. However, for the H-IFN-γ group, uterine mucosa bleeding, necrosis and excoriation were observed using microscopy. Visual observation revealed marroon, swelling, crassitude and no embryo in the uterus, which are obvious indicators of abortion. These results indicate that IFN-γ plays a regulatory role in IL-18 expression in the uterus and peripheral blood of pregnant rats at the post-implantation stage. Moreover, high levels (500 IU/g) of IFN-γ influence normal pregnancy at the early stages in rats by downregulating IL-18 expression in the uterus and peripheral blood and increasing the number of peripheral leukocytes, consequently triggering termination of pregnancy.
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Affiliation(s)
- Li-Fang Si
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, Henan 471003, China
| | - Shou-Yan Zhang
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, Henan 471003, China
| | - Chun-Sheng Gao
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, Henan 471003, China
| | - Shu-Lin Chen
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, Henan 471003, China
| | - Jin Zhao
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, Henan 471003, China
| | - Xiang-Chao Cheng
- College of Animal Science and Technology, Henan University of Science and Technology, Luoyang, Henan 471003, China
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Cift T, Uludag S, Aydin Y, Benian A. Effects of amniotic and maternal CD-146, TGF-β1, IL-12, IL-18 and IFN-γ, on adverse pregnancy outcome. J Matern Fetal Neonatal Med 2012; 26:21-5. [PMID: 22913276 DOI: 10.3109/14767058.2012.722712] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
OBJECTIVE Our aim was to determine the effects of maternal serum and amniotic fluid levels of cluster of differentiation 146 (CD-146), transforming growth factor (TGF)-β1, interleukin (IL)-12, IL-18, and interferon (IFN)-γ on intrauterine growth restriction and preterm labor. METHODS In this retrospective cohort study, we included pregnant women who underwent amniocentesis at Istanbul University Cerrahpasa Medical School. Women were followed up to labor. The study group comprised 23 women with adverse pregnancy outcomes (intrauterine growth restriction and preterm labor), and the control group comprised 105 women with normal pregnancy outcome. RESULTS The study group was further divided into two subgroups of preterm labor and intrauterine growth restriction. No significant differences were found for IL-12, IFN-γ, TGF-β1, or CD-146 levels in either plasma or amniotic fluid between the study and control groups. Serum IL-18 levels were similar, but the amniotic fluid level of IL-18 was significantly higher in the intrauterine growth restriction subgroup than that in the preterm labor subgroup and that in the control group (p < 0.01). CONCLUSIONS Increased IL-18 level in amniotic fluid may be a predictor for intrauterine growth restriction. IL-12, IFN-γ, TGF-β1, and CD-146 were not related to adverse pregnancy outcome.
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Affiliation(s)
- Tayfur Cift
- Department of Obstetrics and Gynecology, Cerrahpasa Medical Faculty of Istanbul University, Istanbul, Turkey
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Rull K, Nagirnaja L, Laan M. Genetics of recurrent miscarriage: challenges, current knowledge, future directions. Front Genet 2012; 3:34. [PMID: 22457663 PMCID: PMC3306920 DOI: 10.3389/fgene.2012.00034] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2012] [Accepted: 02/24/2012] [Indexed: 01/09/2023] Open
Abstract
Recurrent miscarriage (RM) occurs in 1-3% of couples aiming at childbirth. Due to multifactorial etiology the clinical diagnosis of RM varies. The design of genetic/"omics" studies to identify genes and biological mechanisms involved in pathogenesis of RM has challenges as there are several options in defining the study subjects (female patient and/or couple with miscarriages, fetus/placenta) and controls. An ideal study would attempt a trio-design focusing on both partners as well as pregnancies of the couple. Application of genetic association studies focusing on pre-selected candidate genes with potential pathological effect in RM show limitations. Polymorphisms in ∼100 genes have been investigated and association with RM is often inconclusive or negative. Also, implication of prognostic molecular diagnostic tests in clinical practice exhibits uncertainties. Future directions in investigating biomolecular risk factors for RM rely on integrating alternative approaches (SNPs, copy number variations, gene/protein expression, epigenetic regulation) in studies of single genes as well as whole-genome analysis. This would be enhanced by collaborative network between research centers and RM clinics.
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Affiliation(s)
- Kristiina Rull
- Human Molecular Genetics Research Group, Institute of Molecular and Cell Biology, University of Tartu Tartu, Estonia
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Daher S, Mattar R, Gueuvoghlanian-Silva BY, Torloni MR. Genetic Polymorphisms and Recurrent Spontaneous Abortions: An Overview of Current Knowledge. Am J Reprod Immunol 2012; 67:341-7. [DOI: 10.1111/j.1600-0897.2012.01123.x] [Citation(s) in RCA: 57] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2012] [Accepted: 02/06/2012] [Indexed: 01/09/2023] Open
Affiliation(s)
- Silvia Daher
- Department of Obstetrics; Sao Paulo Federal University; Sao Paulo; Brazil
| | - Rosiane Mattar
- Department of Obstetrics; Sao Paulo Federal University; Sao Paulo; Brazil
| | | | - Maria R. Torloni
- Department of Obstetrics; Sao Paulo Federal University; Sao Paulo; Brazil
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Messaoudi S, Dandana M, Magdoud K, Meddeb S, Ben Slama N, Hizem S, Mahjoub T. Interleukin-18 promoter polymorphisms and risk of idiopathic recurrent pregnancy loss in a Tunisian population. J Reprod Immunol 2012; 93:109-13. [PMID: 22386125 DOI: 10.1016/j.jri.2011.12.002] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2011] [Revised: 12/17/2011] [Accepted: 12/19/2011] [Indexed: 02/04/2023]
Abstract
IL-18 is a pro-inflammatory cytokine that regulates the differentiation and effector functions of CD4+ (Th1) and CD8+ (CTL) T cells, which are implicated in the pathogenesis of recurrent pregnancy loss (RPL). We investigated the association of the IL-18 gene promoter single nucleotide polymorphisms (SNPs) -656C/A (rs1946519), -137G/C (rs187238), -119A/C (rs360718), and -105G/A (rs360717), by TaqMan assays in analysis in 470 Tunisian women comprising 235 RPL cases and 235 multi-parous controls. The association of IL-18 alleles, genotypes, and haplotypes with RPL was evaluated by Fisher's exact test and regression analysis. The frequency of minor alleles -105G/A (P<0.001) and -656C/A (P<0.001), but not -119A/C (P=0.93) or -137G/C (P=0.32), were higher in RPL cases. Significant differences were also noted in the genotype distribution of -105G/A (P<0.001) and -656C/A (P<0.001) between cases and controls. Four-locus (-656C/A, -137G/C, -119A/C, -105G/A) IL-18 haplotype analysis identified AGAA (corrected P<0.001), and CGAA (corrected P<0.001) haplotypes to be associated with increased RPL risk, after adjusting for age and BMI. These results demonstrate that -105G/A and -656C/A IL-18 variants are significantly associated with RPL.
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Affiliation(s)
- Safia Messaoudi
- Research Unit of Hematological and Autoimmune Diseases, University of Monastir, Monastir, Tunisia
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Wang Y, Zhang X, Zhang Y, Xu H, Fang G. Expression and localization of IL-18 in the hypothalamic-pituitary-ovarian axis of non-pregnant, pregnant, and abortive rats. J Reprod Immunol 2011; 92:45-53. [PMID: 21920610 DOI: 10.1016/j.jri.2011.07.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2010] [Revised: 07/05/2011] [Accepted: 07/19/2011] [Indexed: 12/14/2022]
Abstract
Cytokines present in the reproductive system play an important role both in the modulation of immune responses to infectious challenge and in the establishment and maintenance of pregnancy. Interleukin 18 (IL-18) has been regarded as an important regulator of innate and acquired immune response, but its expression and distribution in the hypothalamic-pituitary-ovarian axis remain unclear. In this paper, the expression and distribution of IL-18 in non-pregnant, pregnant, and early abortive rats were examined using an ultra-sensitive immunohistochemical streptavidin-peroxidase method, enzyme-linked immunosorbent assay, and reverse transcription-polymerase chain reaction. The results showed that IL-18 expression in the pituitary, in follicular ovaries, and in the corpus luteum of abortive rats were significantly lower than that of pregnant and non-pregnant rats. However, the staining of IL-18 in the hypothalamus, interstitial glands of the ovary, and uterus of abortive rats was strikingly stronger than those of the non-pregnant ones. IL-18 mRNA expression in rat uterus was detected in all groups, whereas IL-18 mRNA content in abortive rat uterus was significantly higher than in normal pregnant rats. Further, IL-18 in the peripheral blood serum of abortive rats was significantly lower than in same-period normal pregnant rats. The differential expression of IL-18 in early abortion suggests that IL-18 may be related to the underlying mechanisms of abortion.
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Affiliation(s)
- Yuesi Wang
- Institute of Stem cell and tissue engineering, Binzhou Medical University, Yantai, Shandong 264003, China
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Al-Khateeb GM, Sater MS, Finan RR, Mustafa FE, Al-Busaidi AS, Al-Sulaiti MA, Almawi WY. Analysis of interleukin-18 promoter polymorphisms and changes in interleukin-18 serum levels underscores the involvement of interleukin-18 in recurrent spontaneous miscarriage. Fertil Steril 2011; 96:921-6. [PMID: 21840518 DOI: 10.1016/j.fertnstert.2011.06.079] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2011] [Revised: 06/29/2011] [Accepted: 06/30/2011] [Indexed: 02/03/2023]
Abstract
OBJECTIVE To evaluate the association of interleukin-18 (IL-18) promoter single-nucleotide polymorphisms rs1946519 (-656C/A), rs187238 (-137G/C), rs360718 (-119A/C), and rs360717 (-105G/A) and changes in IL-18 serum levels with recurrent spontaneous miscarriage (RSM). DESIGN Case-control study. SETTING Outpatient obstetrics and gynecology clinics. PATIENT(S) Women with confirmed RSM (n = 282), and 283 age- and ethnically matched controls. INTERVENTION(S) None. MAIN OUTCOME MEASURE(S) IL-18 genotyping was accomplished by allelic discrimination assays; serum IL-18 levels were measured by ELISA. RESULT(S) The minor allele frequencies of rs360717 and rs1946519, but not rs360718 or rs187238, were higher in patients with RSM. Significant differences in the distribution of the rs360717 and rs1946519 genotypes were noted between patients and controls, and both rs360717 and rs1946519 IL-18 single-nucleotide polymorphisms showed significant association with RSM under additive, dominant, and recessive models. Lower serum IL-18 levels were seen between patients and controls and were more pronounced in rs360717 and rs1946519 heterozygous and homozygous genotypes. Four-locus (rs1946519/rs187238/rs360718/rs360717) IL-18 haplotype analysis identified that the AGAA (Pc<.001), CGAA (Pc<.001), and ACAG (Pc=.018) haplotypes were associated with a reduction in IL-18 secretion and with increased RSM risk, after adjustments for body mass index, menarche, and gravida. CONCLUSION(S) These results demonstrated that reduced IL-18 levels and rs360717 and rs1946519 IL-18 variants are significantly associated with RSM.
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Affiliation(s)
- Ghada M Al-Khateeb
- Department of Medical Biochemistry, College of Medicine and Medical Sciences, Arabian Gulf University, Manama, Bahrain
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Franchim CS, Sass N, Mattar R, Pendeloski KPT, Lin LH, Torloni MR, Daher S. Inflammatory Mediators Gene Polymorphisms in Preeclampsia. Hypertens Pregnancy 2010; 30:338-46. [DOI: 10.3109/10641950903455389] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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