This study was undertaken to investigate the antioxidant/oxidant status in recurrent miscarriage patients. Antioxidants including glutathione peroxidase (GPx), catalase (CAT), glutathione reductase (GR), reduced glutathione (GSH) and selenium (Se), as well as the oxidants hydrogen peroxide (H2O2), oxidised glutathione (GSSG) and lipid peroxidation were assayed in plasma, whole blood and placental tissue of non-pregnant women (NP), healthy pregnant women (HP), and recurrent miscarriage (RM) patients. Results indicated that all antioxidant activities and levels in plasma and whole blood of HP women were consistently moderately lower, and much more significantly lower in RM patients when both were compared to those seen in NP women (P<0.05 and P<0.001, respectively). Furthermore, whereas plasma antioxidant activities and levels were significantly lower in RM patients, those of whole blood and placental tissue were much more significantly lower when compared with HP women (P<0.001). Concurrent with these findings there were consistent increases of equal statistical significance and magnitude in the levels of all investigated oxidants assayed in all samples when compared in between subjects of the study as indicated above. Data thus illustrated a distinct shift in favor of oxidative reactions and reactive oxygen species (ROS) generation, and very significant decreases in the GSH/GSSG ratios in whole blood and placental tissue of RM patients when compared to HP and NP women (P<0.001). The above noted oxidative stress could have been a major causative factor of recurrent miscarriage.
Abortion, Habitual/*blood/*epidemiology ; Adult ; Antioxidants/analysis ; Biomarkers/*blood ; Catalase/blood ; Female ; Glutathione/blood ; Glutathione Peroxidase/blood ; Glutathione Reductase/blood ; Humans ; Hydrogen Peroxide/analysis ; Lipid Peroxidation ; *Oxidative Stress ; Placenta/metabolism ; Pregnancy ; Reactive Oxygen Species/metabolism ; Saudi Arabia/epidemiology ; Selenium/blood

OBJECTIVETo investigate the relationship between recurrent spontaneous abortion (RSA) and the level of interferon-γ (IFN-γ) and interleukin-4 (IL-4) in peripheral blood and gingival crevicular fluid of patients with chronic periodontitis.

METHODSFifty pregnant women with recurrent spontaneous abortion (gestational age: 5 - 28 weeks) and 40 pregnant women (gestational age: 39 - 41 weeks) were included and their periodontal status was examined. The level of IFN-γ and IL-4 in gingival crevicular fluid and peripheral blood was detected by enzyme-linked immunosorbent assay.

RESULTSNine RSA women and 5 in control group had periodontitis. The prevalence of periodontitis in RSA group was 18% (9/50) and 13% (5/40) in the control group (P < 0.05). The probing depth, attachment loss and bleeding index in RSA group were higher than those in the control group (P < 0.05). The level of IFN-γ was (52.98 ± 17.56) ng/L in gingival crevicular fluid of RSA group and (25.25 ± 7.93) ng/L in control group (P < 0.01). The level of IL-4 was (15.43 ± 1.77) ng/L in gingival crevicular fluid of RSA group and (19.62 ± 4.04) ng/L in control group (P < 0.01). The content of IFN-γ was (27.79 ± 3.59) ng/L in peripheral blood of RSA group and (18.39 ± 2.65) ng/L in control group (P < 0.05). The content of IL-4 was (15.88 ± 0.95) ng/L in peripheral blood of RSA group and (22.98 ± 4.30) ng/L in control group (P < 0.001). The content of cytokines in gingival crevicular fluid and peripheral blood in the same group was positively related (r > 0.8, P < 0.001).

CONCLUSIONSPregnant women of RSA have a higher chance of getting periodontitis. The change in the level of cytokines in periodontal tissue could result in excursion of maternal intrauterine immune environment to T-helper 1 (Th1). Periodontitis was related to RSA.

Abortion, Habitual ; blood ; metabolism ; Adult ; Chronic Periodontitis ; blood ; epidemiology ; metabolism ; Female ; Gingival Crevicular Fluid ; metabolism ; Humans ; Interferon-gamma ; blood ; metabolism ; Interleukin-4 ; blood ; metabolism ; Pregnancy ; Pregnancy Trimester, First ; Pregnancy Trimester, Second ; Prospective Studies