Hyperemesis gravidarum is a cytokine storm?

Aim. To study the systemic response of proinflammatory cytokines in women suffering from VP. The main group consisted of 47 women with VP, which was divided into 3 subgroups according to severity: the 1st – included 16 patients with mild VP, the 2nd – 15 with moderate severity, and the 3rd – 16 women with severe VP. The control group consisted of 10 pregnant women with a physiological course without signs of toxicosis. Interleukins (IL-1β, IL-6, TNFα) were determined in the blood serum of pregnant women by solid-phase ELISA using Cytokine test kits (St. Petersburg, Russia). With increasing severity of toxicosis, there is a significant increase in IL-1β in severe VP – 1.9 times higher than the same value of the norm (p 0.05), 2 times higher than in mild vomiting (p 0.05), and in 1.7 times – with moderate VP (p 0.05). The study of the level of IL-6 revealed a directly proportional increase in the indicator with increasing severity of toxicosis in relation to the control indicator: with mild vomiting – 1.9 times (p 0.05), with moderate vomiting – 2.6 times (p 0.001), and in severe VP – 2.9 times (p 0.0001). A significant decrease in the level of TNFα was observed with increasing severity of toxicosis in relation to the control indicator: with mild vomiting – by 1.5 times (p 0.05), with moderate vomiting – by 1.9 times (p 0.05), and with severe VP – 2.1 times (p 0.05). Excessive secretion of proinflammatory cytokines IL-1β and IL-6 (2 and 3 times, respectively), exceeding the norm, with a sharp suppression of TNFα production (2 times) can be considered as predictors of a “cytokine storm”, clinically occurring with multiple organ failure up to death if the pregnancy is not terminated in a timely manner.