Inflammation and Pregnancy

Abstract

Inflammation is a process by which tissues respond to various insults. It is characterized by upregulation of chemokines, cytokines, and pattern recognition receptors that sense microbes and tissue breakdown products. During pregnancy, the balance of Th1 (cell-mediated immunity) and Th2 (humoral immunity) cytokines is characterized by an initial prevalence of Th2 cytokines, followed by a progressive shift toward Th1 predominance late in gestation, that when is abnormal, may initiate and intensify the cascade of inflammatory cytokine production involved in adverse pregnancy outcomes. Maternal and placental hormones may affect the inflammatory pathway. Hypoxia and the innate immune response are 2 adaptive mechanisms by which organisms respond to perturbation in organ function, playing a major role in spontaneous abortion, intrauterine growth restriction, preeclampsia, and preterm delivery. The interaction between tissue remodeling factors, like matrix metalloproteinases, and vasoactive/hemostatic factors, like prostaglandin and coagulation factors, mediates this adaptive response.

Antioxidant Status in Normal Pregnancy and Preeclampsia upon Multivitamin-Mineral Supplementation in the Region of Vojvodina

“…Preeclampsia is considered a disorder strongly related to oxidative stress [1], [2], [6], [8], [11]- [13], [16]- [18]. But even in normal pregnancy there is evidence of oxidative stress.…”

“…Due to metabolic changes and low grade inflammation, pregnancy is a condition of increased susceptibility to oxidative stress [1], [2]. Several organs in pregnancy show increased basal oxygen consumption and changes in substrate energy use resulting in increased mitochondrial mass and production of reactive oxygen species (ROS) [3].…”

Endocrine immune interactions in human parturition

“…Production of MMP-1, MMP-3 and MMP-9 from resident fibroblasts (Ito et al, 1991) and smooth muscle cells (Watari et al, 1999) may also be increased by IL-1β in the cervix whilst downregulating the expression of tissue inhibitor of metalloproteinase (TIMP)-2, an endogenous inhibitor of MMP-2 (Watari et al, 1999), with these events being further amplified by NF-κB production. NF-κB itself may be A c c e p t e d M a n u s c r i p t activated via toll-like receptor (TLR)-4 by degraded extracellular matrix proteins such as fragments of fetal fibronectin, degraded during cervical remodelling, thus reinforcing the ongoing sterile inflammation of labour (Challis et al, 2009). Thus, at the end of pregnancy and during labour, the cervix having remained firm and closed despite increasing pressure during pregnancy, begins, under the influence of a host of inflammatory mediators, to soften and dilate.…”

Pro- and antiinflammatory cytokines in threatened miscarriages

“…This could be explained by the fact that IL-6 has both pro-and antiinflammatory properties. The classification of IL-6 as a Th1-type cytokine in studies on preterm labor 56,57 or as a Th2 type cytokine in early pregnancy [58][59][60][61] remains controversial. Recently, it has been demonstrated that IL-6 is involved in the promotion of Th2 differentiation and the inhibition of Th1 polarization.…”