Deregulated Immune Milieu Early during Pregnancy could discriminate women vulnerable to develop Gestational Hypertensive Disorders

Objective: To evaluate the potential of serum tumor ne-crosis factor-α (TNF-α), interleukin (IL)-6 and 10, and placental growth factor (PLGF) as early biomarkers for gestational hypertension (GHTN) or preeclampsia (PE) by measuring their serum levels at 12 gestational weeks (GW) and correlating them with blood pressure (BP).   
Patients & Methods: BP was measured 4-weekly during pregnancy and women who developed significantly high-er BP measures than the at-12th GW measures were con-sidered as GHTN and were followed up, women who de-veloped proteinuria were collected as the PE group, while the remaining were collected as the GHTN group and women who sustained normal BP measures till the 38th GW were collected as the normotensive (NT) group.   
Results: Serum TNF-α and IL-6 levels were significantly elevated in PE (n=24) and GHT women (n=41) compared to NT women (n=65). PE women had significantly low-er serum IL-10 and PLGF levels than both NT and GHT women. Elevated IL-6 and TNF-α demonstrated a high positive predictive value for the development of GHT. Conversely, low serum IL-10, PLGF, and a low IL-10/IL-6 ratio were identified as sensitive early predictors of PE. High serum TNF-α levels emerged as the most crucial early predictor of hypertension development before the 34th GW. 
Conclusion: elevated serum levels of IL-6 and TNF-α at the 12th GW especially in obese pregnant women might identify women vulnerable to developing GHTN, while low serum levels of PLGF and IL-10 or IL-10/IL-6 ratio might function as early predictors for the development of PE.