IMMUNE DYSREGULATION IN PREECLAMPSIA: DIFFERENTIAL EXPRESSION OF TUMOUR NECROSIS FACTOR-ALPHA AND INTERLEUKIN-10 AND THEIR ASSOCIATION WITH CLINICAL, LABORATORY, AND PERINATAL OUTCOMES

Objective: Preeclampsia (PE) is a multifactorial hypertensive disorder of pregnancy characterized by systemic inflammation and endothelial dysfunction. Aberrant immune responses, particularly an imbalance between pro-inflammatory and anti-inflammatory cytokines, have been implicated in their pathogenesis. This study evaluated the expression of tumor necrosis factor-alpha (TNF-á) and interleukin-10 (IL-10) in earlyonset PE (EOPE) and late-onset PE (LOPE) compared with normotensive pregnancies, and examined their correlation with clinical, laboratory, andperinatal outcomes. Methods: A total of 200 pregnant women were recruited, including EOPE (n=50), LOPE (n=50), and healthy controls (n=100). Demographic, clinical, and laboratory parameters were recorded. Quantitative real-time polymerase chain reaction was used to assess messenger RNA expression of TNF-á and IL-10 in peripheral blood samples. Statistical analyses included analysis of variance with post hoc testing, Pearson’s correlation, and regression modeling. Results: EOPE and LOPE groups demonstrated significantly higher systolic and diastolic blood pressures (BP) and proteinuria compared with controls (p<0.001). TNF-á expression was markedly upregulated in EOPE compared with LOPE and controls (p<0.001), whereas IL-10 expression was significantly downregulated in both PE groups (p<0.01). The TNF-á/IL-10 ratio was highest in EOPE, reflecting a pronounced pro-inflammatory shift. Correlation analysis revealed that TNF-á positively correlated with BP, proteinuria, and adverse perinatal outcomes, while IL-10 levels negatively correlated with these parameters. Composite analysis integrating molecular and clinical data reinforced the stronger immune dysregulation in EOPE compared with LOPE. Conclusion: This study highlights a distinct immunological profile in PE characterized by elevated TNF-á, reduced IL-10, and an exaggerated TNF-á/IL-10 ratio, particularly in EOPE. These findings underscore the role of immune imbalance in disease severity and suggest that cytokine profiling may serve as a potential biomarker and therapeutic target in PE management.