Maternal peripheral T-helper 1-type and T-helper 2-type immunity in nonpreeclamptic twin pregnancies

Effects of fetal number on acute phase proteins, cortisol, and hematological parameters in ewes during the periparturient period

Many subclinical diseases associated with inflammation occur in sheep during the periparturient period. Clinical symptoms are usually detected at an advanced stage of the disease; therefore, there are considerable risks of permanent health disorders in fetuses or dams. Determination of acute phase proteins (APPs) as markers of inflammation may allow for an earlier diagnosis and effective treatment. Furthermore, multi-fetus pregnancies are often associated with hematological disturbances. The study objective was to compare plasma concentrations of serum amyloid A (SAA), haptoglobin (Hp), fibrinogen (Fb), and cortisol in ewes bearing one and two fetuses in the period from 2 weeks before to 2 weeks after parturition as well as to determine hematological parameters in peripheral blood. There was an important effect of fetal number on APP and cortisol concentrations in periparturient ewes. There was a greater concentration of SAA, Hp, Fb, and cortisol in ewes bearing two fetuses compared with those bearing one fetus. Profiles for APP and cortisol concentrations and hematological parameters were similar for ewes bearing one and two fetuses, and trends were within normal reference ranges for the periparturient period. Furthermore, there were no differences in values for hematological variables between ewes bearing one and two fetuses. with there being no ewes with anemia. In summary, separate determination of the previously undefined physiological ranges of APPs and cortisol for ewes bearing one and two fetuses may facilitate diagnosis of subclinical disorders and enable comparison of laboratory test results with different reference values for ewes bearing different numbers of fetuses.

Sex-specific influence of the vacuolar adenosine triphosphatase a2 isoform on outcome in twin pregnancies

PROBLEM

The influence of fetal sex on immune responses in multifetal pregnancies remains incompletely elucidated. The a2 isoform of vacuolar adenosine triphosphatase (a2V) is expressed on the cell membrane of maternal lymphoid cells and contributes to down-regulation of pro-inflammatory immune responses during gestation. The association between fetal sex and a2V expression on peripheral blood mononuclear cells (PBMCs) from mothers with twin gestations was assessed.

METHOD OF STUDY

Patients in this prospective study were 93 women with twin pregnancies in their mid-second or early third trimester-27 with two male, 30 with two female and 36 with one male and one female fetus. PBMCs were isolated and a2V was measured by ELISA in cell lysates. Demographic and clinical data were subsequently obtained and correlations between a2V and fetal sex, birthweight and pregnancy outcome were assessed by the Mann-Whitney and Spearman rank correlation tests.

RESULTS

The mean a2V level was highest when both fetuses were male (2.0 ng/mL) and lowest when both were female (1.5 ng/mL; P = 0.0184). Only when both fetuses were female did the a2V concentration negatively correlate with birthweight of the 1st (P = 0.0011) and 2nd (P = 0.0044) born fetus and with gestational age at delivery (P = 0.0018). There were no associations between a2V and these outcomes in male only or mixed twin pregnancies.

CONCLUSION

We conclude that the a2V-mediated regulation of maternal immunity during twin pregnancies is influenced by fetal sex.

T helper 1/t helper 2 cell immunity in preeclamptic twin pregnancy

Preeclampsia has been classified into two types on the basis of the T helper (Th)1/Th2 balance: Th1-predominant type and Th2 predominant type. In this study, we examined the Th1/Th2 ratio in peripheral Th cells in 11 patients with preeclamptic twin pregnancies, 11 normal (nonpreeclamptic) twin pregnancies, 11 preeclamptic singleton pregnancies, and 11 normal singleton pregnancies. The average Th1/Th2 ratio in the patients with preeclamptic twin pregnancy was 8.3 +/- 3.4 (mean +/- SD), which was similar to those in patients with normal singleton and twin pregnancies and significant lower than that in patients with preeclamptic singleton pregnancies (p = 0.003). The present results suggest that the mechanisms of preeclampsia differ between singleton and twin pregnancies.

Maternal peripheral T helper 1-type and T helper 2-type immunity in women during the first trimester of twin pregnancy

INTRODUCTION

This study investigated the T helper Th1:Th2 balance in twin pregnancies compared with singleton pregnancies during the first trimester.

METHODS

Blood samples were taken from 24 women with a singleton pregnancy and 14 women with twin pregnancy at 8-9 weeks' gestation to examine the ratios of Th1:Th2 and serum human chorionic gonadotropin (hCG) and progesterone levels.

RESULTS

The average ratio of Th1:Th2 in the twin pregnancies was significantly lower than that in singleton pregnancies (7.3+/-2.3 vs. 10.5+/-2.2, p<0.05). There were negative correlations between the Th1:Th2 ratio and serum hCG levels (mIU/ml) (Th1:Th2 ratio = 14.5-4.52 x 10(-5)xhCG, r(2)=0.41, p<0.05) and between the Th1:Th2 ratio and serum progesterone levels (ng/dl; Th1:Th2 ratio = 23.0-0.63 x progesterone, r(2)=0.36, p<0.05).

CONCLUSION

Our findings show marked predominance of Th2 type cytokines occurring in twin pregnancies is related to the increase in trophoblasts during the first trimester.

Relation between maternal serum adenosine deaminase and plasma adenosine levels in twin pregnancies

OBJECTIVE

The relationship between adenosine deaminase activity and plasma adenosine was examined in non-pregnancy as well as in singleton and twin pregnancies.

METHODS

Whole-blood samples were taken from 11 singleton and 11 dichorionic twin pregnant women during the third trimester. The plasma adenosine levels were assayed with a modified high-performance liquid chromatographic method, while the adenosine deaminase levels were measured enzymatically.

RESULTS

The adenosine deaminase and plasma adenosine levels were both higher in twin pregnancies compared to singleton and non-pregnancies.

CONCLUSION

Increased plasma adenosine is not due to decreased serum adenosine deaminase levels in twin pregnant women.