T LYMPHOCYTE SUB POPULATIONS, CYTOKINES AND PREGNANCY SPECIFIC BETA-1 GLYCOPROTEIN IN ECLAMPSIA

(A CASE STUDY OF KADUNA STATE, NIGERIA)

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Author

Presented To

Department of Medicine

ABSTRACT
A comparative cross-sectional study of eclampticand normal healthy pregnant womenconducted in Ahmadu Bello University Teaching Hospital (ABUTH), Shika Zaria to determine Tcell subpopulations (CD3+, CD4+ and CD8+T lymphocytes); cytokines (Tumor necrosis factor[TNF]-α, Interleukin [IL]-2, IL-4, and IL-10) and Pregnancy Specific beta-1 Glycoprotein (PSG-1) levels in the peripheral blood ofthird trimester women with eclampsia (EC; N=38), normal healthy pregnant and non pregnant women controls(PC; N=38 and NPC; N=38 respectively), age and parity matched, attending labour rooms/wards and Antenatal Clinics (ANC) of Ahmadu Bello University Teaching Hospital Shika,Zaria and four other Hospitals in Kaduna state, Nigeria. Participants with smear positive malaria, seropositive for human immunodeficiency virus (HIV) or any other known clinical infection were excluded from this study. Complete Blood Count (CBC) and T lymphocytesubpopulationswere determined by Sysmex, Auto blood analyzer and Becton Dickinson (BD) FACScount machine using monoclonal anti-T lymphocyte antibody (FITC-Fluorescein isothiocynate labelled) respectively. Cytokines and PSG-1 levels were estimated using Quantikine ELISA kits. Data obtained were analyzed using analysis of variance (ANOVA) to evaluate the difference between parametric data (T-lumphocyte subpopulations) and Kruskal Wallis test to evaluate the difference between nonparametric data (PSG-1 and cytokines). A p-value of less than 0.05 was considered to be significant. Results showed reduction in the levels of mean total Tcells (CD3+ lymphocytes), T helper lymphocyte (CD4+lymphocytes) and ratio of helper-to-suppressor T cells in women with EC and PCcompared NPC(P<05). Eclampsia was associated with a further significant decrease in mean CD3+and CD4+ lymphocytes levels (P<05) compared to PC. In relation to cytokines, women with EC, had a significantly elevated mean serum level of pro-inflammatory cytokine TNF-α x and low levels of anti-inflammatory cytokine IL-10 compared to both PC and NPC (P<0.05). Mean IL 2 levels in the eclamptics were not significantly different from both controls. The mean levels of PSG-1 in the eclamptic women group were not significantly different from PC (P>0.05), while the total white blood cell count, and differential percentage neutrophils count were noted to be elevated among the eclamptic women compared to PC and NPC (P<0.05). The study suggested an association of EC with a dominant pro-inflamatory cytokine environment, which supports the hypothesis of Th 1 response in women with ECas opposed to Th2 response in normal healthy pregnant women. Further studies are required to determine the true status of Th1/Thh2 paradigm shift in established EC. The new information generated in this study provide a basis for the Clinicians, Researchers and the Government of Nigeria to explore, in terms of the strategies for improving and meeting up with health standards as stipulated in the Millenium Development Goals (MDGs).