الفهرس 
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Abstract
This study aimed to assess CD4, IL-10, IL-17 and TNF-a expression in pregnant women to predict pre-eclamptic pregnancy, and to evaluate their association with different clinical and laboratory data, as well as their relation to disease risk factors.
• There was no statistical difference in the median age and the gestational age among cases and controls.
• group I have significantly lower median hemoglobin level (p=0.024) more than group II.
• TLC level was significantly higher in pregnant women with high risk factors for PE group compared to control group (p=0.009).
• There was no statistical difference between two groups regarding platelet count.
• ALT and AST were significantly higher in patients’ group compared to control group (p=0.021, p=0.008 respectively).
• Serum albumin was significantly lower in patients’ group compared to control group (p=0.001).
• No significant differences were found between patients’ group and control group regarding PC and INR as well as bilirubin (total and direct).
• Urea and creatinine were significantly higher in patients’ group compared to control (p=0.048, p<0.001 respectively).
• 24-hour proteinuria had a significant higher mean value of (0.32±0.31 g) in patients’ group than that of control group (0.07±0.05 g) (p<0.001).
• There was no significant difference for the percentages of CD4+ T helper cells between both groups.
• Intracellular IL-10 level was significantly lower in the patients’ group when compared with the control group (p<0.001).
• Intracellular IL-17 and TNF-α levels were significantly higher in the patients’ group when compared with the control group (p<0.001 for both).
• The percentages of CD4+TNF-α+ (Th1) and CD4+IL-17+ (Th17) cells in total CD4+ T cells were significantly higher in the patients’ group when compared with the control group (p<0.001). Contrarily, CD4+IL-10+ (Th2) cell percentage was significantly lower in patients’ group than that of control group (p<0.001).
• Both CD4+TNF-α+/CD4+IL-10+ T cells ratio and the ratio of CD4+IL-17 +/CD4+IL-10+ T cells ratio were significantly higher in patients’ group when compared with that of the control group (p<0.001).
• There was a strong negative correlation TNFa-CD4 / IL10-CD4 and IL10-CD4 (rho= -0.785, p<0.001).
• Among all participants, the area under the IL-10 ROC curve AUC was 0.926 with sensitivity and specificity of 97.1% and 89.1% respectively, when the cut-off value was ≤1.7 (p<0.001). The area under the IL-17 ROC curve AUC was 0.921 with sensitivity and specificity of 94.1% and 87% respectively, when the cut-off value was >3.3 (p<0.001). The area under the TNFα ROC curve AUC was 0.887 with sensitivity and specificity of 91.2% and 84.8% respectively, when the cut-off value was >2.5 (p<0.001).
• Also, the area under the IL10-CD4 % ROC curve AUC was 0.910 with sensitivity and specificity of 97.1% and 87% respectively, when the cut-off value was ≤1.2 (p<0.001). The area under the IL17-CD4 % ROC curve AUC was 0.927 with sensitivity and specificity of 94.1% and 89.1% respectively, when the cut-off value was >2 (p<0.001). The area under the TNFα-CD4 % ROC curve AUC was 0.911 with sensitivity and specificity of 97.1% and 84.8% respectively, when the cut-off value was >1.3 (p<0.001).
• As well as, the area under the IL17-CD4 / IL10-CD4 cell ratio ROC curve has the best performance and AUC was 0.959 with sensitivity and specificity of 97.1% and 91.3% respectively, when the cut-off value was >0.25 (p<0.001). The area under the TNFα-CD4 / IL10-CD4 cell ratio ROC curve AUC was 0.943 with sensitivity and specificity of 100% and 89.1% respectively, when the cut-off value was >0.28 (p<0.001).