Abstract

Preterm parturition is often preceded by systemic infection and cytokines are recognized as the principle
mediators of a variety of immunologic and pathophysiologic events in infection. The study was designed to
examine whether cocaine affects synthesis and secretion of cytokines. Among the cytokines, tumor necrosis
factor (TNF-alpha and Interleukines (IL-1-beta and IL-6) were chosen because of their presumptive role in infection.
For in vitro study, blood was obtained from mothers who were drug free (control); lymphocytes were isolated
and stimulated with lipopolysacchrides. The synthesis of TNF-alpha, IL-1-beta and IL-6 was examined in the presence of
2.1-mu-M of cocaine. The data show that cocaine stimulated TNF-alpha synthesis (p<0.01) but had no effect on IL-1-beta and IL-6 synthesis.
For in ex vivo study, cytokine levels were measured in fetal cord blood in cocaine users. The data were similar to
that found in vitro study.
In cocaine users, cortisol blood level increased significantly in the fetal cord blood (p<0.01) but not in the
mother, however, in mothers with known infection (positive control), blood cortisol level increased significantly
without similar effect in the fetus.
The babies born to cocaine users were significantly of low birth weights (p<0.05) the incidence of pre -rupture of
membranes (PPROM) increased significantly (p<0.001) in cocaine users.
The data show that cocaine selectively increased TNF-alpha synthesis and secretion. Higher cortisol level in the fetal
cord blood suggests that in cocaine users fetus is more susceptible to infection than the mother.

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