IMMUNE DYSREGULATION IN PREECLAMPSIA: DIFFERENTIAL EXPRESSION OF TUMOUR NECROSIS FACTOR-ALPHA AND INTERLEUKIN-10 AND THEIR ASSOCIATION WITH CLINICAL, LABORATORY, AND PERINATAL OUTCOMES

POGULA ASHALATHA; SRIKANTH TOKALI; KALAKANTI SHWETA; MUTHULAKSHMI R; ASHOK VARDHAN N

doi:10.22159/ajpcr.2025v18i12.56976

Authors

POGULA ASHALATHA Department of Medical Physiology, Meenakshi Institute of Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram, Tamil Nadu, India.
SRIKANTH TOKALI Department of Physiology, Government Medical College, Mahabubnagar, Telangana, India.
KALAKANTI SHWETA Department of Physiology, KNR University of Health Sciences, Warangal, Telangana, India.
MUTHULAKSHMI R Department of Medical Physiology, Meenakshi Institute of Medical College and Research Institute, Meenakshi Academy of Higher Education and Research, Kanchipuram, Tamil Nadu, India
ASHOK VARDHAN N Department of Biochemistry, Singareni Institute of Medical Sciences, Ramagundam, Telangana, India.

DOI:

https://doi.org/10.22159/ajpcr.2025v18i12.56976

Keywords:

Preeclampsia, Early-onset preeclampsia, Late-onset preeclampsia, Tumor necrosis factor-alpha, Interleukin-10

Abstract

Objective: Preeclampsia (PE) is a multifactorial hypertensive disorder of pregnancy characterized by systemic inflammation and endothelial dysfunction. Aberrant immune responses, particularly an imbalance between pro-inflammatory and anti-inflammatory cytokines, have been implicated in their pathogenesis. This study evaluated the expression of tumor necrosis factor-alpha (TNF-á) and interleukin-10 (IL-10) in earlyonset PE (EOPE) and late-onset PE (LOPE) compared with normotensive pregnancies, and examined their correlation with clinical, laboratory, andperinatal outcomes.

Methods: A total of 200 pregnant women were recruited, including EOPE (n=50), LOPE (n=50), and healthy controls (n=100). Demographic, clinical, and laboratory parameters were recorded. Quantitative real-time polymerase chain reaction was used to assess messenger RNA expression of TNF-á and IL-10 in peripheral blood samples. Statistical analyses included analysis of variance with post hoc testing, Pearson’s correlation, and regression modeling.

Results: EOPE and LOPE groups demonstrated significantly higher systolic and diastolic blood pressures (BP) and proteinuria compared with controls (p<0.001). TNF-á expression was markedly upregulated in EOPE compared with LOPE and controls (p<0.001), whereas IL-10 expression was significantly downregulated in both PE groups (p<0.01). The TNF-á/IL-10 ratio was highest in EOPE, reflecting a pronounced pro-inflammatory shift. Correlation analysis revealed that TNF-á positively correlated with BP, proteinuria, and adverse perinatal outcomes, while IL-10 levels negatively correlated with these parameters. Composite analysis integrating molecular and clinical data reinforced the stronger immune dysregulation in EOPE compared with LOPE.

Conclusion: This study highlights a distinct immunological profile in PE characterized by elevated TNF-á, reduced IL-10, and an exaggerated TNF-á/IL-10 ratio, particularly in EOPE. These findings underscore the role of immune imbalance in disease severity and suggest that cytokine profiling may serve as a potential biomarker and therapeutic target in PE management.

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