Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian study

Aim: To assess circulating levels of tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) in mid-gestation pregnant women from South India, with (RPL) and without history of recurrent pregnancy loss (non-RPL) and its correlation with neutrophil to lymphocyte ratio (NLR). M...

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Main Authors: Rashmi Bhuwalka, Sufaya Jameel, Fazul Rahaman, Rajeshwari Bonu, Parveen Jahan
Format: Article
Language:English
Published: Open Exploration Publishing Inc. 2025-04-01
Series:Exploration of Immunology
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Online Access:https://www.explorationpub.com/uploads/Article/A1003189/1003189.pdf
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author Rashmi Bhuwalka
Sufaya Jameel
Fazul Rahaman
Rajeshwari Bonu
Parveen Jahan
author_facet Rashmi Bhuwalka
Sufaya Jameel
Fazul Rahaman
Rajeshwari Bonu
Parveen Jahan
author_sort Rashmi Bhuwalka
collection DOAJ
description Aim: To assess circulating levels of tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) in mid-gestation pregnant women from South India, with (RPL) and without history of recurrent pregnancy loss (non-RPL) and its correlation with neutrophil to lymphocyte ratio (NLR). Methods: Blood samples were collected from 400 pregnant women attending government maternity hospital, Hyderabad, and subjected to enzyme linked immunosorbent assay (ELISA) for cytokines. NLR was calculated from absolute cell counts obtained from hospital records. Mann-Whitney U and Spearman r correlation was conducted as data followed non-normal distribution. Results: We found significantly decreased level of TGF-β and elevated TNF-α, TNF-α/TGF-β (P < 0.0001), and NLR (P = 0.0007) in patients over controls. Receiver operating curve characteristics of TNF-α/TGF-β (area under curve: 0.96) were superior to individual cytokines and NLR for patients when compared to the control group. A negative correlation was noted between NLR and TGF-β in the RPL group (P = 0.0041). Conclusions: Our results are indicative of predominant pro-inflammatory environment during mid-gestation in patients contrary to the anti-inflammatory milieu in controls. This is first study that attempted to connect cytokines with cellular ratio in RPL. The affordability of NLR to track inflammation is promised by its inverse correlation with TGF-β. However, further longitudinal studies are warranted spanning all stages of gestation in normal pregnant and RPL women to establish our observations. The limitations of the study include other factors that drive pro-inflammatory status like emotional dysregulation in women associated with chronic pro-inflammatory status is unexplored.
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spelling doaj-art-4e00a05ae4f04a1ab3069bbae460b3722025-08-20T03:05:24ZengOpen Exploration Publishing Inc.Exploration of Immunology2768-66552025-04-015100318910.37349/ei.2025.1003189Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian studyRashmi Bhuwalka0Sufaya Jameel1Fazul Rahaman2Rajeshwari Bonu3Parveen Jahan4Department of Zoology, Maulana Azad National Urdu University, Hyderabad 500032, Telangana, IndiaDepartment of Zoology, Maulana Azad National Urdu University, Hyderabad 500032, Telangana, IndiaDepartment of Zoology, Maulana Azad National Urdu University, Hyderabad 500032, Telangana, IndiaObstetrics and Gynecology Department, Niloufer Hospital, Hyderabad 500028, Telangana, IndiaDepartment of Zoology, Maulana Azad National Urdu University, Hyderabad 500032, Telangana, IndiaAim: To assess circulating levels of tumor necrosis factor-alpha (TNF-α) and transforming growth factor-beta (TGF-β) in mid-gestation pregnant women from South India, with (RPL) and without history of recurrent pregnancy loss (non-RPL) and its correlation with neutrophil to lymphocyte ratio (NLR). Methods: Blood samples were collected from 400 pregnant women attending government maternity hospital, Hyderabad, and subjected to enzyme linked immunosorbent assay (ELISA) for cytokines. NLR was calculated from absolute cell counts obtained from hospital records. Mann-Whitney U and Spearman r correlation was conducted as data followed non-normal distribution. Results: We found significantly decreased level of TGF-β and elevated TNF-α, TNF-α/TGF-β (P < 0.0001), and NLR (P = 0.0007) in patients over controls. Receiver operating curve characteristics of TNF-α/TGF-β (area under curve: 0.96) were superior to individual cytokines and NLR for patients when compared to the control group. A negative correlation was noted between NLR and TGF-β in the RPL group (P = 0.0041). Conclusions: Our results are indicative of predominant pro-inflammatory environment during mid-gestation in patients contrary to the anti-inflammatory milieu in controls. This is first study that attempted to connect cytokines with cellular ratio in RPL. The affordability of NLR to track inflammation is promised by its inverse correlation with TGF-β. However, further longitudinal studies are warranted spanning all stages of gestation in normal pregnant and RPL women to establish our observations. The limitations of the study include other factors that drive pro-inflammatory status like emotional dysregulation in women associated with chronic pro-inflammatory status is unexplored.https://www.explorationpub.com/uploads/Article/A1003189/1003189.pdfproinflammatoryanti-inflammatorycytokinesimmune shiftnlrtnf-α/tgf-β
spellingShingle Rashmi Bhuwalka
Sufaya Jameel
Fazul Rahaman
Rajeshwari Bonu
Parveen Jahan
Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian study
Exploration of Immunology
proinflammatory
anti-inflammatory
cytokines
immune shift
nlr
tnf-α/tgf-β
title Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian study
title_full Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian study
title_fullStr Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian study
title_full_unstemmed Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian study
title_short Predominant pro-inflammatory environment in mid-gestation pregnant women with history of recurrent pregnancy loss: a South Indian study
title_sort predominant pro inflammatory environment in mid gestation pregnant women with history of recurrent pregnancy loss a south indian study
topic proinflammatory
anti-inflammatory
cytokines
immune shift
nlr
tnf-α/tgf-β
url https://www.explorationpub.com/uploads/Article/A1003189/1003189.pdf
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