Perfusion with lipopolysaccharide differently affects the secretion of tumor necrosis factor-alpha and interleukin-6 by term and preterm human placenta

This study has compared the functional capacity of term and preterm placentas in terms of production of pro-inflammatory cytokines in a perfusion system reflecting their ability to react to inflammatory agents, such as lipopolysaccharide (LPS), mimicking the situation of chorioamnionitis. We have demonstrated that term placentas secrete higher levels of tumor necrosis factor (TNF)-alpha compared with preterm placentas. Moreover, TNF-alpha secretion was significantly higher after exposure to LPS in the maternal and fetal sides of term placentas. In contrast, in preterm placentas, only the fetal side responded with a significant increase in secretion of TNF-alpha after exposure to LPS. The maternal side of term placentas secreted significantly higher amounts of interleukin (IL)-6 compared with preterm placentas. Exposure to LPS significantly decreased IL-6 secretion from the maternal side in both term and preterm placentas. Moreover, the fetal side of term placentas secreted significantly lower amounts of IL-6 compared with preterm placentas. In summary, this study has indicated that term and preterm placental tissues have a differing responsiveness to LPS stimulation, with term placentas disposed to a higher TNF-alpha:IL-6 ratio. Release of cytokines into fetal circulation is less than into the maternal side. However, TNF-alpha is released into fetal circulation after LPS stimulation and this may be relevant to the etiology of chorioamnionitis.