Role of cytokines in altitude-associated preeclampsia R. Daniela Dávila, MD *,1,3,5 , Colleen G. Julian, PhD *,1,2 , Vaughn A Browne, MD, PhD 1 , Lillian Toledo-Jaldin, MD 5 , Megan J Wilson 1,2 , Armando Rodriguez 5 , Enrique Vargas, MD 5 , and Lorna G. Moore, PhD 1,4 1 Altitude Research Center, University of Colorado Denver, Aurora, CO 2 Dept of Health and Behavioral Science, University of Colorado Denver, Denver, CO 3 Cardiovascular Pulmonary Research Laboratory, University of Colorado Denver, Aurora, CO 4 Graduate School of Arts and Sciences, Wake Forest University, Winston-Salem, NC 5 Instituto Boliviano de Biología de Altura, La Paz, Bolivia Abstract BACKGROUND—Preeclampsia (PE) is more common at high than low altitude and contributes to the altitude-related decline in birth weight. Since inflammatory markers are implicated in PE, we asked if such markers differed in PE vs. normotensive pregnant (NORM) women residing at high altitude (3600-4100 m), and were related to uterine artery blood flow (UA BF) or fetal growth. METHODS—Subjects were 33 Andean pregnant residents of Bolivia, comprising six with early- onset PE (ᚢ 34 wk), 12 with late-onset PE (> 34 wk), and 15 gestational-age matched NORM. Maternal pro- and anti-inflammatory cytokines were measured using a multiplex bead-based assay and UA BF by Doppler ultrasound. RESULTS—PE compared to NORM women had higher levels of the pro-inflammatory cytokines IL-6 and IL-8 as well as higher levels of the anti-inflammatory cytokine IL-1ra, but only IL-6 levels were higher when gestational age was controlled. Women with early- vs. late-onset PE had higher TNFα levels, and higher IL-6 was negatively correlated with birth weight in all women at ᚢ 34 wk. We suggest that pro-inflammatory factors influence both the timing and severity of PE at high altitude. Keywords Andean; birth weight; fetal growth; hypoxia © 2011 International Society for the Study of Hypertension in Pregnancy. Published by Elsevier B.V. All rights reserved. Address for correspondence: Colleen G. Julian, PhD, Altitude Research Center, Mail Stop F-524, University of Colorado Denver, 12469 East 17th Place, Bldg. 400, Aurora, Colorado 80045, Phone number: 303-724-1621 / 415-994-3312, Fax number: 303-724-1660, colleen.julian@ucdenver.edu. * Co-first authors of this manuscript. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. NIH Public Access Author Manuscript Pregnancy Hypertens. Author manuscript; available in PMC 2013 January 1. Published in final edited form as: Pregnancy Hypertens. 2012 January ; 2(1): 65–70. doi:10.1016/j.preghy.2011.11.001. NIH-PA Author Manuscript NIH-PA Author Manuscript NIH-PA Author Manuscript