Immune dysregulation in preeclampsia: differential expression of TNF-α and IL-10 and their association with clinical, laboratory, and perinatal outcomes
DOI:
https://doi.org/10.2478/AMB-2026-0052Keywords:
preeclampsia, early-onset preeclampsia, late-onset preeclampsia, tumor necrosis factor-alpha, interleukin-10Abstract
Abstract. Background: 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 its pathogenesis. This study evaluated the expression of tumor necrosis factor-alpha (TNF-α) and interleukin-10 (IL-10) in early-onset (EOPE) and late-onset preeclampsia (LOPE) compared with normotensive pregnancies, and examined their correlation with clinical, laboratory, and perinatal outcomes. Materials and 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 PCR was used to assess mRNA expression of TNF-α and IL-10 in peripheral blood samples. Statistical analyses included ANOVA with post-hoc testing, Pearson’s correlation, and regression modeling. Results: EOPE and LOPE groups demonstrated significantly higher systolic and diastolic blood pressures and proteinuria compared with controls (p<0.001). TNF-α 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-α/IL-10 ratio was highest in EOPE, reflecting a pronounced pro-inflammatory shift. Correlation analysis revealed that TNF-α positively correlated with blood pressure, 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 preeclampsia characterized by elevated TNF-α, reduced IL-10, and an exaggerated TNF-α/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 preeclampsia.
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