Male gender promotes an increased inflammatory response to lipopolysaccharide in umbilical vein blood

Objectives: To establish gender-specific differences in maternal and fetal immune response in healthy human fetuses at term. Methods: Forty-five women with elective caesarean sections for uncomplicated singleton pregnancies were recruited for two studies. Using a multiplex biomarker immunoassay system, unstimulated maternal and fetal plasma concentrations of interleukin (IL)-1 beta, IL-1ra, IL-6, IL-8, macrophage inflammatory protein (MIP)-1 alpha, and tumor necrosis factor (TNF)-alpha were measured from one study population. Lipopolysaccharide (LPS)-stimulated cytokine response was measured in a second study. Results: There were no significant gender differences in either maternal or fetal unstimulated plasma cytokine concentrations, but concentrations of the proinflammatory cytokines IL-1 beta and IL-6 were significantly greater in male fetal LPS-stimulated samples than in female fetal samples. Conclusions: Blood of male fetuses mounts a larger pro-inflammatory response to lipopolysaccharide (LPS). This heightened response could be a critical pathway in promoting premature rupture of membranes (PPROM) and may be associated with life long differential gender response to infection.