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ORIGINAL ARTICLE: Endogenous Adenosine Down-Modulates Mid-Trimester IntraAmniotic Tumor Necrosis Factor-α Production

Authors

  • Uma Perni,

    1. Department of Obstetrics and Gynecology, New York Hospital Medical Center of Queens, New York, NY, USA;
    2. Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA
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  • Devrim Sezen,

    1. Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA
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  • Ann Marie Bongiovanni,

    1. Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA
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  • Iara M. Linhares,

    1. Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA
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  • Daniel Skupski,

    1. Department of Obstetrics and Gynecology, New York Hospital Medical Center of Queens, New York, NY, USA;
    2. Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA
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  • Steven S. Witkin

    1. Division of Immunology and Infectious Diseases, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, New York, NY, USA
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Steven S. Witkin, Department of Obstetrics and Gynecology, Weill Medical College of Cornell University, 525 East 68th Street, Box 35, New York, NY 10065, USA.
E-mail: switkin@med.cornell.edu

Abstract

Problem  To determine whether adenosine in amniotic fluid down-regulates pro-inflammatory cytokine production.

Method of study  Mid-trimester amniotic fluid from 21 women was incubated ex vivo in the presence or absence of human adenosine deaminase, the enzyme that irreversibly degrades adenosine. After 24 hr, supernatants were assayed by ELISA for tumor necrosis factor-α (TNF-α), interleukin (IL)-6, and IL-10. Clinical parameters were obtained after completion of laboratory testing.

Results  Inclusion of adenosine deaminase resulted in a median increase in TNF-α production from 0.9 to 7.3 pg/mL (P = 0.0014). IL-6 production exhibited a non-significant median increase from <2.0 to 53.0 pg/mL (P = 0.0780). Median IL-10 production increased slightly from a median of <0.2 to 1.3 pg/mL. Adenosine deaminase-stimulated TNF-α production was proportional to parity and unrelated to gestational age, time of delivery, maternal age or indication for amniocentesis.

Conclusion  Adenosine deaminase treatment increases TNF-α production by ex vivo-cultured amniotic fluid. Adenosine contributes to immune modulation in the amniotic cavity.

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