The role of inflammatory biomarkers in the development and progression of pre-eclampsia: a systematic review and meta-analysis

Frontiers in Immunology

Immunology

Jiarun Song¹  Chunmei Li¹  Mingxuan Cui¹  Yixin Liu¹  Yanwen Fu¹  Xiaohan Guan¹  Jian Zhao²  Chaofan Wang²  Caishun Zhang³  Qing Zhang³  Jing Dong⁴ 

[1] School of Basic Medicine, Clinical Medicine Department of Medical College, Qingdao University, Qingdao, Shandong, China;School of Public Health, Medical College, Qingdao University, Qingdao, Shandong, China;Special Medicine Department, Medical College, Qingdao University, Qingdao, Shandong, China;Special Medicine Department, Medical College, Qingdao University, Qingdao, Shandong, China;Physiology Department, Medical College, Qingdao University, Qingdao, Shandong, China;

关键词: pre-eclampsia;    biomarkers;    inflammation;    meta-analysis;    IL-6;    IL-10;    TNF;   

DOI  :  10.3389/fimmu.2023.1156039

 received in 2023-02-01, accepted in 2023-05-18,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundPre-eclampsia (PE) is a pregnancy complication associated with maternal and fetal morbidity and mortality. Among the potential pathogenesis discussed, inflammation is considered an essential initiator of PE. Previous studies have compared the levels of various inflammatory biomarkers that indicate the existence of PE; however, the relative levels of pro-inflammatory and anti-inflammatory biomarkers and their dynamic changes during PE progression remain unclear. This knowledge is essential to explain the occurrence and progression of the disease.ObjectiveWe aimed to identify the relationship between inflammatory status and PE using inflammatory biomarkers as indicators. We also discussed the underlying mechanism by which inflammatory imbalance contributes to PE by comparing the relative levels of pro-inflammatory and anti-inflammatory biomarkers. Furthermore, we identified additional risk factors for PE.MethodsWe reviewed PubMed, Embase, and the Cochrane Library for articles published until 15th September 2022. Original articles that investigated inflammatory biomarkers in PE and normal pregnancy were included. We selected healthy pregnant women as controls. The inflammatory biomarkers in the case and control groups were expressed as standardized mean differences and 95% confidence intervals using a random-effects model. Study quality was assessed using the Newcastle-Ottawa Scale. Publication bias was assessed using Egger’s test.ResultsThirteen articles that investigated 2,549 participants were included in this meta-analysis. Patients with PE had significantly higher levels of C-reactive protein (CRP), interleukin (IL)-4, IL-6, IL-8, IL-10, and tumor necrosis factor (TNF) than the controls. CRP and pro-inflammatory cytokine levels were higher than those of anti-inflammatory cytokines. Patients with gestational age > 34 weeks had significantly higher IL-6 and TNF levels. Patients with higher systolic blood pressure had significantly higher IL-8, IL-10, and CRP levels.ConclusionInflammatory imbalance is an independent risk factor for PE development. Impairment of the anti-inflammatory system is a crucial initiating factor for PE development. Failed autoregulation, manifested as prolonged exposure to pro-inflammatory cytokines, leads to PE progression. Higher levels of inflammatory biomarkers suggest more severe symptoms, and pregnant women after 34 weeks of gestation are more susceptible to PE.

【 授权许可】

Unknown   
Copyright © 2023 Guan, Fu, Liu, Cui, Zhang, Zhang, Li, Zhao, Wang, Song and Dong