Dysregulation in the balance between pro- and anti-inflammatory cytokines promotes the development of idiopathic preterm premature rupture of membranes

Objectives To estimate the expression of TNF-α, IFN-γ, IL-4, IL-10, suppressors of cytokine signaling (SOCS1) and SOCS3 in cases of idiopathic preterm premature rupture of membranes (pPROM) and gestational age matched healthy pregnant controls. Material and Methods 30 cases of Idiopathic pPROM with gestational age 26-34 weeks (n = 30) and 30 healthy pregnant controls were enrolled. Serum interferon-gamma (IFN-γ) and interleukin-10 (IL-10) were measured by enzyme-linked immunosorbent assay (ELISA). Messenger ribonucleic acid (mRNA) expression tumor necrosis factor-alpha (TNF-α), IFN-γ, IL-4, IL-10, SOCS1 and SOCS3 was measured by quantitative polymerase chain reaction. Result Serum levels of IFN-γ were higher, whereas serum levels of IL-10 were lower in cases of pPROM compared to gestational age-matched healthy pregnant controls. Expression of TNF-α, IFN-γ, SOCS1, and SOCS3 was higher, whereas expression of IL-4 and IL-10 was lower in idiopathic pPROM compared to gestational age healthy pregnant controls. Conclusion Our study suggests that idiopathic pPROM is a pro-inflammatory state characterized by increased expression of pro-inflammatory cytokines and decreased expression of anti-inflammatory cytokines. There is also an increased expression of SOCS1 and SOCS3, most probably a compensatory mechanism, which seems to be inadequate in combating the pro-inflammatory state. Development of these markers will help identify pregnant women at risk and provide directions to reduce the global burden of pPROM and associated neonatal adverse outcomes.