Kadar TNF-􀁄, IL-6 dan Trofoblas pada Preeklampsia-Eklampsia

Abstract

The level of TNF- 􀁄, IL-6 and trophoblast in preeclampsia-eclampsia Background: Pre eclampsia–eclampsia (PE-E) is the highest cause of maternal death. Up to the present time, PE-E is still the disease of theories, where the patofisiology is still unclear. Invitro research reported that increase of TNF–􀄮 and IL–6 in PE-E will cause the placenta hypoxia. This condition will trigger the secretion of pro inflammatory cytokine from fetoplacenta which will cause the rejection in trophoblast invasion. The purpose of this study was to analyze the association between the TNF–􀄮 and IL–6 rate/expression with infarct and placental tissue apoptosis. Methods: The study was done during the period of July 2005–October 2005. The subjects were 17 parturient non PE-E and 18 parturient PE-E who delivered at Dr. Kariadi Hospital Semarang. The TNF–􀄮 and IL–6 rate/expression were measured from the blood sample and placental tissue with ELISA method and imunohystochemical by acidine orange painting. The difference of TNF–􀄮 and IL–6 rate/expression with the size of infarct and apoptosis were tested by Mann-Whitney test and the correlation with Spearman test. Results: The mean size of infarct in normal subjects was 12.5% compared to PE-E which was 35.3% (p=0.001). The percentage of apoptosis in normal and PE-E subjects were 32.3% and 71.0% respectively (p=0.001). The mean rate of TNF–􀄮 of placenta and blood serum in normal and PE-E subjects were 1.7 pg/mL, 2.0 pg/mL, 2.3 pg/mL and 2.8 pg/mL respectively (P1 and P2 <0.001). The mean placenta and blood serum IL-6 in normal and PE-E subjects were 0.6 pg/mL, 1.3 pg/mL, 1.4 pg/mL, and 2.0 pg/mL respectively showing significant difference between the two groups. There were strong associations between placenta and serum TNF–􀄮 and IL–6 with the size of infarct and percentage of placenta apoptosis. Conclusions: The level of pro inflammatory cytokine in serum as well as in placenta of subjects with PE-E is higher than those without PE-E and there is strong correlation between pro inflammatory cytokine expression in serum and placenta with the size of infarct and placental apoptosis.