The Role of Antioxidant Vitamin C on Imminent Abortion through Interaction of Superoxide Dismutase, Interferon-γ, Interleukin-4, Vascular Cells Adhesion Molecule-1, and Decidual Spiral Arteries Blood Flow
Budi Handono1*, Firman F. Wirakusumah1, Johanes C. Mose1, Tri Hanggono Achmad2
Open Journal of Obstetrics and Gynecology, 2015, 5, 103-114
Imminent abortion needs more serious attention since it remains a big problem in Indonesia considering its epidemiology, morbidity, mortality, and prognosis. In fact, some cases can still be prevented. The objective of this study was to determine pathogenesis, diagnosis, and prognosis of imminent abortion through the role of antioxidant vitamin C in the interaction of superoxide dismutase (SOD), interferon-γ (IFN-γ), interleukin-4 (IL-4), vascular cells adhesion molecule-1 (VCAM- 1), and decidual spiral artery resistance index (DSA RI). This study took 10 months from March to December 2007 at Obstetrics and Gynecology Department of Medical Faculty of Padjadjaran University/Hasan Sadikin Hospital, Bandung. Sixty pregnant women who met the inclusion and exclusion criteria were divided into two groups with the random clinical trial method, double-blind with repeated measurements. Data were analyzed statistically using t test, Mann-Whitney, Rank Spearman, Wilcoxon, t paired, and diagnostic test. The results of this study showed that the incidence of abortion in vitamin C group was 9 cases (30%) and placebo group was 13 cases (43.3%).
There was a significant difference in SOD, IFN-γ, IL-4 and VCAM-1 level between groups of women with and without abortion (p < 0.001). There was a significant difference of SOD level between women with abortion 655.8 (163.6) U/gHb and placebo group 824.5 (106.7) U/gHb after vitamin C administration (p = 0.008). The cutoff point of SOD was ≤992 U/gHb which showed quite high sensitivity, specificity, accuracy, and significant difference (p <0.001).
The cutoff point abortion of DSA resistance index was ≥0.55 with 45% accuracy (p = 0.002). The highest change of IL-4 level was 60.7% in vitamin C group and VCAM-1 was −2.2% (p < 0.05) after vitamin C administration.
There was a negative correlation in SOD changes toward IL-4 changes after vitamin C administration (r = −0.523) (p = 0.003), a positive correlation between SOD changes and IL-4 changes (0.597) (p < 0.001), a negative correlation between SOD changes and VCAM-1 changes (r = −0.737) (p <0.001) and a negative correlation between SOD changes and DSA RI changes (r = −0.208) (p = 0.022). There were significant changes in the increment of IL-4 and SOD level (p < 0.001) and a decline in IFN-γ, VCAM-1 and DSA RI (p < 0.001) before and after vitamin C administration. In conclusion, there was a correlation between the increase of SOD level with the decrease of INF-γ level and the increase of IL-4 level in imminent abortion after vitamin C administration. There was a correlation between the increase of SOD level with the decrease of DSA RI and the decrease of VCAM-1 level in imminent abortion after vitamin C administration. In abortion, there was a decrease of SOD and IL-4 level, as well as an increase of IFN-γ, VCAM-1, and DSA RI level.
Keywords Imminent Abortion, SOD, VCAM-1, IFN -γ, IL-4, DSA RI