Anticytokine therapy in preterm labor: current knowledge and future perspectives

Area of Science:

• Obstetrics and Gynecology
• Neonatology
• Immunology

Background:

• Preterm birth affects up to 10% of pregnancies and is a leading cause of neonatal mortality.
• Current treatments for preterm birth are often ineffective, highlighting an urgent clinical need.
• Infections and asphyxia associated with preterm birth pose significant risks to neonates.

Purpose of the Study:

• To review preclinical and clinical trials on preterm labor.
• To identify promising molecular targets for preterm labor treatment.
• To focus on anticytokine therapy for preterm labor.

Main Methods:

• Literature review of English language preclinical and clinical trials.
• Analysis of molecular targets for preterm labor.
• Evaluation of anticytokine therapy, including bikunin.

Main Results:

• Preterm birth is a complex, heterogeneous condition with no current treatment for ruptured fetal membranes.
• Preventative treatments are necessary to manage preterm labor and prevent fetal infection.
• Modulating the pro-inflammatory cytokine network represents a potential new treatment paradigm.
• Several agents like betamimetics, magnesium sulfate, progesterone, and oxytocin antagonists have been reported.
• Preclinical and clinical trials of anticytokine therapy, specifically bikunin, show promise in reducing preterm labor exacerbations.

Conclusions:

• Anticytokine therapy is a promising novel approach for preterm labor.
• Bikunin has demonstrated usefulness and safety in preclinical and clinical trials.
• Anticytokine therapy is nearing clinical readiness for preterm birth management.