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Presenting Twins Are Exposed to Higher Levels of Inflammatory Mediators than Nonpresenting Twins as Early as the Midtrimester of Pregnancy

Authors
 Seung Mi Lee  ;  Joong Shin Park  ;  Errol R. Norwitz  ;  Sun Min Kim  ;  JoonHo Lee  ;  Chan-Wook Park  ;  Byoung Jae Kim  ;  Jong Kwan Jun 
Citation
 PLOS ONE, Vol.10(6) : e0125346, 2015 
Journal Title
PLOS ONE
Issue Date
2015
MeSH
Adult ; Amniotic Fluid/metabolism ; Female ; Humans ; Inflammation Mediators/metabolism* ; Maternal Exposure* ; Morbidity ; Mortality ; Pregnancy ; Pregnancy Trimester, Second* ; Prenatal Exposure Delayed Effects* ; Respiratory Tract Diseases/epidemiology ; Respiratory Tract Diseases/etiology ; Twins*
Abstract
OBJECTIVE: Presenting twins are less likely to develop respiratory complications than non-presenting twins. The precise reason for this difference is not well understood, although it is known that the presence of inflammation reduces the risk of respiratory morbidity at birth. To further investigate this association, we compared the concentrations of inflammatory biomarkers in mid-trimester amniotic fluid (AF) of asymptomatic twin pairs.

STUDY DESIGN: The study population consisted of women with twin pregnancies who underwent mid-trimester amniocentesis (15-20 weeks) for routine clinical indications and delivered at term. AF was analyzed for pro-inflammatory cytokines (IL-1β, IL-2, IL-4, IL-5, IL-6, IL-8, IL-10, IL-12, IL-13, IL-15, IFN-γ, TNF-α), matrix metalloproteinases (MMP-1, MMP-2, MMP-3, MMP-8, MMP-9, MMP-12), and chemokines (Complement Factor D/Adipsin, Serpin E1/PAI-1, Adiponectin/Acrp30, CRP, CCL2/MCP-1, Leptin, Resistin) using Luminex Performance Assay multiplex kits. Data were analyzed using Wilcoxon signed rank test.

RESULTS: A total of 82 twin pairs were enrolled. Mid-trimester AF concentrations of IL-8, MMP-8, CRP, MCP-1, leptin, and resistin were significantly higher in the presenting twin compared with the non-presenting twin (p<0.05 for each). Differences in AF concentrations of IL-8, MMP-8, and CRP persisted after adjustment for the fetal growth restriction at the time of birth and chorionicity.

CONCLUSION: These data suggest that, as early as the mid-trimester, the presenting fetus in an otherwise uncomplicated twin pregnancy is exposed to higher levels of pro-inflammatory mediators (especially IL-8, MMP-8, and CRP) than its non-presenting co-twin. Whether this pro-inflammatory milieu reduces the risk of neonatal respiratory morbidity at birth or has other functional implications needs to be further evaluated.
Files in This Item:
T201506500.pdf Download
DOI
10.1371/journal.pone.0125346
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Obstetrics and Gynecology (산부인과학교실) > 1. Journal Papers
Yonsei Authors
Lee, Joon Ho(이준호)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/155666
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