TY - JOUR
T1 - Racial disparity in amniotic fluid concentrations of tumor necrosis factor (TNF)-α and soluble TNF receptors in spontaneous preterm birth
AU - Menon, Ramkumar
AU - Thorsen, Poul
AU - Vogel, Ida
AU - Jacobsson, Bo
AU - Morgan, Nicole
AU - Jiang, Lan
AU - Li, Chun
AU - Williams, Scott M.
AU - Fortunato, Stephen J.
N1 - Funding Information:
The study was supported by Thrasher Research Funds, Salt Lake City, UT. The funding organization had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; and preparation, review, or approval of the manuscript. The study protocol submitted by the authors was reviewed and approved by their board of directors at the inspection of the project.
PY - 2008/5
Y1 - 2008/5
N2 - Objective: Preterm birth rate in the United States is higher in blacks than whites. It has been hypothesized that a differential inflammatory response may explain this disparity. The objective of this study is to examine the inflammatory cytokine, tumor necrosis factor (TNF)-α and soluble TNF receptor concentrations (sTNFR1 and sTNFR2) in the amniotic fluid of black and white women at delivery. Study Design: Amniotic fluid samples were collected during active labor from 158 cases (preterm births, gestational age 220/7 weeks to 360/7 weeks, 52 black and 106 white) and 175 controls (term births, gestational age 370/7 weeks to 420/7 weeks, 87 black and 88 white) at Centennial Women's Hospital, Nashville, TN. Amniotic fluid TNF-α, sTNFR1, and sTNFR2 concentrations and the molar ratios of TNF-α to its receptors were compared between cases and controls within each racial group. Results: Median TNF-α concentration was associated with preterm birth when whites and blacks were analyzed together, with cases having higher values (191.5 pg/mL) than controls (68.9 pg/mL; P < .001). There were no significant associations with sTNFR1 or sTNFR2 concentrations between cases (2409.4 and 2934.3 pg/mL, respectively) and controls (2759.9 and 3084.1 pg/mL, respectively) when the racial groups were analyzed together (P = .08, P = .4, respectively). Black cases associated with higher TNF-α concentrations (1287.0 pg/mL in cases and 67.3 pg/mL in controls; P < .001). In whites there was no association between TNF-α and preterm birth (P = .3). The molar ratio of TNF-α/total sTNFR (R1 plus R2) associated with higher TNF-α in black cases, compared with black controls (P < .001). There was no significant association between white cases and controls for ligand receptor ratios (P = .3). Conclusion: The TNF-α/sTNFR profile in pregnancy differs between racial groups, suggesting a difference in bioavailability of TNF-α. The larger molar ratio of TNF-α/sTNFR in black cases may be indicative of a TNF-α mediated pathological process of preterm birth in blacks but not in whites.
AB - Objective: Preterm birth rate in the United States is higher in blacks than whites. It has been hypothesized that a differential inflammatory response may explain this disparity. The objective of this study is to examine the inflammatory cytokine, tumor necrosis factor (TNF)-α and soluble TNF receptor concentrations (sTNFR1 and sTNFR2) in the amniotic fluid of black and white women at delivery. Study Design: Amniotic fluid samples were collected during active labor from 158 cases (preterm births, gestational age 220/7 weeks to 360/7 weeks, 52 black and 106 white) and 175 controls (term births, gestational age 370/7 weeks to 420/7 weeks, 87 black and 88 white) at Centennial Women's Hospital, Nashville, TN. Amniotic fluid TNF-α, sTNFR1, and sTNFR2 concentrations and the molar ratios of TNF-α to its receptors were compared between cases and controls within each racial group. Results: Median TNF-α concentration was associated with preterm birth when whites and blacks were analyzed together, with cases having higher values (191.5 pg/mL) than controls (68.9 pg/mL; P < .001). There were no significant associations with sTNFR1 or sTNFR2 concentrations between cases (2409.4 and 2934.3 pg/mL, respectively) and controls (2759.9 and 3084.1 pg/mL, respectively) when the racial groups were analyzed together (P = .08, P = .4, respectively). Black cases associated with higher TNF-α concentrations (1287.0 pg/mL in cases and 67.3 pg/mL in controls; P < .001). In whites there was no association between TNF-α and preterm birth (P = .3). The molar ratio of TNF-α/total sTNFR (R1 plus R2) associated with higher TNF-α in black cases, compared with black controls (P < .001). There was no significant association between white cases and controls for ligand receptor ratios (P = .3). Conclusion: The TNF-α/sTNFR profile in pregnancy differs between racial groups, suggesting a difference in bioavailability of TNF-α. The larger molar ratio of TNF-α/sTNFR in black cases may be indicative of a TNF-α mediated pathological process of preterm birth in blacks but not in whites.
KW - cytokines
KW - ethnicity
KW - inflammation
KW - prematurity
KW - preterm labor
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U2 - 10.1016/j.ajog.2007.11.025
DO - 10.1016/j.ajog.2007.11.025
M3 - Article
C2 - 18279834
AN - SCOPUS:42749096696
SN - 0002-9378
VL - 198
SP - 533.e1-533.e10
JO - American journal of obstetrics and gynecology
JF - American journal of obstetrics and gynecology
IS - 5
ER -