The significance of interleukin-6 concentrations in cervicovaginal fluid: its relation to umbilical cord plasma and the influence of antibiotic treatment

Abstract

This study was performed to correlate cervicovaginal fluid and umbilical cord plasma level of IL-6 and IL-8 in patients with premature rupture of the membranes (PROM) and to see the effect of antibiotics on those concentrations. As a part of a randomized controlled trial of treatment in PROM with antibiotics, cervicovaginal fluid was sampled before delivery for measurement of IL-6 and IL-8 and for bacteria from 36 patients less than 36 weeks of gestation. Umbilical cord plasma was also collected. Concentrations of IL-6 and IL-8 were measured by an ELISA. Neonatal infections were noted in a total of 9 cases, including bacteria detection (Escherichia coli 2 cases, GBS and Streptococcus constellata) in 4 cases. Correlation between IL-6 in cervicovaginal fluid and in cord plasma (r = 0.881, p < 0.0001) was stronger than that of IL-8 (r = 0.469, p < 0.01). The difference of concentrations in IL-6 and IL-8 was not significant between cases with (n = 20) and without (n = 16) ampicillin. Our observation indicates that the measurement of IL-6 concentrations in cervicovaginal fluid is a useful marker for PROM patients who are more likely to develop neonatal infection and the antibiotic treatment does not necessarily produce their beneficial effects on fetuses at the risk of infection.

Initial experience using Sivelestat to manage preterm labor with a bulging fetal membrane in pregnant women

“…As evidence, Matsuda et al 8 reported that the difference in concentrations of IL-6 and IL-8 in umbilical cord blood and cervicovaginal fluid did not vary significantly between women with or without antibiotic therapy during preterm labor. Moreover, Kanayama et al 9 reported that antibiotics and UTI has a role in the inhibition of preterm delivery through suppression of cytokines and inflammatory mediators.…”

Effects of Antibiotic Treatment on the Concentrations of Interleukin-6 and Interleukin-8 in Cervicovaginal Fluid

“…Tanaka et al [13] showed that cervicovaginal IL-8 contributed to term and preterm parturition. We have shown that IL-6 and IL-8 concentrations in cervicovaginal fluid are high in the cases of neonatal infection and both cytokines in cervicovaginal fluid correlate well with those in cord plasma [5]. Therefore, we think the measurement of IL-6 and IL-8 in cervicovaginal fluid is a useful method.…”

“…For this assay the inter-assay coefficients of variation were 4.8-8.9% and 6.2-9.0% for IL-6 and IL-8, respectively, and the intra-assay coefficients of variation were 4.7-5.7% and 4.5-6.6% for IL-6 and IL-8, with ranges of 10-4,400 and 12.5-300 pg/ml, respectively, and the sensitivities of 10 and 12.5 pg/ml, respectively [5].…”

“…Sterile saline solution (3 ml) was instilled in the posterior vaginal fornix with a 5-ml plastic syringe and was aspirated from the posterior fornix with the same syringe. The specimens were immediately centrifuged at 1,800 g for 5 min at room temperature and at least 1.0 ml of supernatant was collected, and then stored at -20°C until assay [5]. Maternal fever, CRP and white blood cell (WBC) counts were recorded simultaneously.…”

“…However, transabdominal amniocentesis is by no means noninvasive and is not applied to all patients with PROM. We have shown that concentrations of IL-6 and IL-8 in both cervicovaginal fluid and umbilical cord plasma were high in the presence of neonatal infection and that the concentrations in both sites correlated well in patients with preterm PROM [5]. Therefore, we undertook the present study to resolve the following questions: Are there any differences in the concentrations of IL-6 and IL-8 depending on presence or absence of clinical infection?…”