Serum Tumor Necrosis Factor-alpha ( TNF-alpha) Levels in Women with Recurrent Pregnancy Loss

Choi, B C; Yoo, K J; Lee, J P; Baik, E C; Cho, D H; Kang, I S

Abstract

Pregnancy must be considered as a successful allotransplant and certain forms of recurrent spontaneous abortions (RSA) are probably due to ""transplant rejection"". Tumor necrosis factor-alpha (TNF-alpha)may play a key role in the rejection of transplants as elevated TNF-alpha serum levels have been found in organ transplantation patients during acute rejection crisis (Herrmann and Mertelsmann 1989). In this study, we measured the serum levels of TNF-alpha to elucidate the relationship between TNF-alpha and RSA, and to evaluate the value of TNF-alpha as a new prognostic marker in RSA. Sixty-seven women visited to Samsung Cheil Hospital from November, 1994 to August, 1995 of whom 15 were diagnosed as healthy and nonpregnant (Group A), 29 were dignosed as having RSA (Group B), 15 were diagnosed as pregnant with no complications (Group C), and 8 were of diagnosed as having an abortion between the 6th and 12th week of pregnancy (Group D). The blood levels of TNF-alpha were measured by use of QuantikineTM HS Immunoassay kit with a sensitivity of 0.125 pg/mL for the benchtop assay (R&D systems). The average serum level (Mean +/- SEM) of TNF-alpha in Group A, B, C and D were 1.89 +/- 0.18 pg/ml, 2.95 +/- 0.46 pg/mL, 2.42 +/- 0.26 pg/mL, and 3.55 +/- 1.31 pg/mL, respectively. The level of TNF-alpha in pregnant women was relatively higher than that of non-pregnant women, however, no stastically significant differences were observed between these two groups. In the total study population, neither age nor number of prior pregnancy losses significantly correlated with TNF-alpha serum levels. There was no difference between women who had abortions caused by known etiology and those who successfully carried to 28 weeks (2.450.68 pg/ml versus 2.420 +/- 6 pg/mL). However, women who had abortions caused by unknown etiology showed an increase in serum TNF-alpha compared to women with normal pregnancies (4.65 +/- 2.59 pg/mL versus 2.42 +/- 0.26 pg/mL, relatively). Similarly, women with a history of unexplained recurrent abortion were more likely to secrete TNF-alpha than healthy, nonpregnant women (4.11 +/- 0.93 pg/mL versus 1.89 +/- 0.18 pg/mL, p < 0.05). These data suggest that unexplained recurrent abortion might be correlated with increased serum TNF-alpha levels.