| An elevated fetal interleukin-6 concentration can be observed in fetuses with anemia due to Rh alloimmunization: implications for the understanding of the fetal inflammatory response syndrome. | |
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MedLine Citation:
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PMID: 20701435 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: The fetal inflammatory response syndrome (FIRS) has been described in the context of preterm labor and preterm prelabor rupture of the membranes and is often associated with intra-amniotic infection/inflammation. This syndrome is characterized by systemic fetal inflammation and operationally defined by an elevated fetal plasma interleukin (IL)-6. The objective of this study was to determine if FIRS can be found in fetuses with activation of their immune system, such as the one observed in Rh alloimmune-mediated fetal anemia. METHODS: Fetal blood sampling was performed in sensitized Rh-D negative women with suspected fetal anemia (n=16). Fetal anemia was diagnosed according to reference range nomograms established for the assessment of fetal hematologic parameters. An elevated fetal plasma IL-6 concentration was defined using a cutoff of >11 pg/ml. Concentrations of IL-6 were determined by immunoassay. Non-parametric statistics were used for analysis. RESULTS: (1) The prevalence of an elevated fetal plasma IL-6 was 25% (4/16); (2) there was an inverse relationship between the fetal hematocrit and IL-6 concentration -- the lower the hematocrit, the higher the fetal IL-6 (r=-0.68, p=0.004); (3) fetuses with anemia had a significantly higher plasma IL-6 concentration than those without anemia (3.74 pg/ml, interquartile range (IQR) 1.18-2.63 vs. 1.46 pg/ml, IQR 1.76-14.7; p=0.02); (4) interestingly, all fetuses with an elevated plasma IL-6 concentration had anemia (prevalence 40%, 4/10), while in the group without anemia, none had an elevated fetal plasma IL-6. CONCLUSIONS: An elevation in fetal plasma IL-6 can be observed in a subset of fetuses with anemia due to Rh alloimmunization. This observation suggests that the hallmark of FIRS can be caused by non-infection-related insults. Further studies are required to determine whether the prognosis of FIRS caused by intra-amniotic infection/inflammation is different from that induced by alloimmunization. |
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Authors:
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Edi Vaisbuch; Roberto Romero; Ricardo Gomez; Juan Pedro Kusanovic; Shali Mazaki-Tovi; Tinnakorn Chaiworapongsa; Sonia S Hassan |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Intramural Date: 2010-08-11 |
Journal Detail:
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Title: The journal of maternal-fetal & neonatal medicine : the official journal of the European Association of Perinatal Medicine, the Federation of Asia and Oceania Perinatal Societies, the International Society of Perinatal Obstetricians Volume: 24 ISSN: 1476-4954 ISO Abbreviation: J. Matern. Fetal. Neonatal. Med. Publication Date: 2011 Mar |
Date Detail:
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Created Date: 2011-02-04 Completed Date: 2011-06-21 Revised Date: 2011-07-25 |
Medline Journal Info:
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Nlm Unique ID: 101136916 Medline TA: J Matern Fetal Neonatal Med Country: England |
Other Details:
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Languages: eng Pagination: 391-6 Citation Subset: IM |
Affiliation:
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Perinatology Research Branch, Intramural Division, NICHD/NIH/DHHS, Hutzel Women's Hospital, Detroit, MI 48201, USA. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adult Anemia / blood, congenital, etiology*, immunology Comprehension Cross-Sectional Studies Female Fetal Diseases / blood, etiology*, immunology Fetus / blood supply Hematocrit Humans Interleukin-6 / blood* Osmolar Concentration Pregnancy Retrospective Studies Rh Isoimmunization / blood, complications* Systemic Inflammatory Response Syndrome / blood, congenital*, etiology*, immunology |
| Grant Support | |
ID/Acronym/Agency:
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ZIA HD002400-18/HD/NICHD NIH HHS |
| Chemical | |
Reg. No./Substance:
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0/Interleukin-6 |
| Comments/Corrections | |
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