Increased T-helper-1-type immunity and decreased T-helper-2-type immunity in patients with preeclampsia

PROBLEM: To examine whether preeclampsia involves type-1 T-helper (Th1) immune hyperactivity. METHOD OF STUDY: Expression of HLA-DR, a cell-surface marker of activation, was analyzed on CD3⁺, CD4⁺, and CD8⁺ T cells in 15 preeclamptic patients and 15 normal pregnant women using flow cytometry. Additonally, peripheral blood mononuclear cells from preeclamptic patients and normal pregnant women were cultured with or without phytomagglutinin (PHA) stimulation, and interleukin (IL)-2, IL-4, interfereon (IFN)-γ, and tumor necrosis factor (TNF)-α concentrations were determined in the supernatant by immunoassays. RESULTS: HLA-DR antigen was expressed more strongly on CD3⁺ T cells in preeclamptic patients than in normal subjects. In preeclampsia, HLA-DR was expressed more strongly in CD8⁺ T cells than in CD4⁺ T cells. More TNF-α, IL-2, and IFN-γ were produced by unstimulated and stimulated cultured peripheral blood mononuclear cells from preeclampsia patients than by those from normal subjects. TNF-α/IL-4, IL-2/IL-4, and IFN-γ/IL-4 ratios were higher in preeclamptic patients than in the normal group. Significant positive correlations were observed between mean blood pressure and concentrations of the Th-1 type cytokines IL-2, IFN-γ, and TNF-α. CONCLUSION: Up-regulation of Th1 responses and down-regulation of Th2 responses occur in preeclampsia.