Increased concentration of 17‐alpha hydroxyprogesterone caproate correlates with IL‐10 to reduce spontaneous preterm birth: 19

Abstract

19 Increased concentration of 17-alpha hydroxyprogesterone caproate correlates with IL-10 to reduce spontaneous preterm birth Christina Megli, Alisse Hauspurg, Steve N. Caritis Magee-Womens Research Institute, University of Pittsburgh, Pittsburgh, PA OBJECTIVE: 17-alpha hydroxyprogesterone caproate (17-OHPC) 250 mg reduces recurrent spontaneous preterm birth in women by 33%. We have previously demonstrated that women with the lowest quartile of plasma concentrations of 17OHPC have elevated rates of preterm birth compared with women in the 2-4 quartiles. The mechanism of action of 17-OHPC is unknown but immune modulation is a possibility. We have previously reported elevated cytokines in the cervical fluid of women with a prior preterm birth. Additionally, circulating cytokines of immunoinhibitory IL-10 and pro-inflammatory TNF alpha have correlated with spontaneous preterm birth. This study sought to determine the relationship between the concentration of 17-OHPC and serum cytokines to determine if efficacy of 17-OHPC correlates with altered immunity. STUDY DESIGN: This was an ancillary study analyzing laboratory results from the placebo controlled, randomized trial of omega-3 supplementation and reduction of recurrent preterm birth. Peripheral blood mononuclear cells were isolated from paired blood samples drawn at 16-22 weeks gestation (baseline) and 25-28 weeks gestation (post treatment). IL-10 and TNF-alpha levels were measured with and without stimulation by lipopolysaccharide by ELISA. All women received 17-OHPC in this trial. 17-OHPC concentrations were determined from a single blood sample obtained