ABSTRACT
Recurrent spontaneous abortion (RSA), which affects 1% to 5% of women of reproductive age, is difficult to treat in the clinical setting. In the investigations of iramunopathogenesis, diagnosis and treatment of RSA since the late 1980s, it was found that RSA was associated with abnormal maternal local or systemic immune response, the pathogenesis of autoimmune RSA was mainly associated with antiphosphlipid antibody (APA), while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance. Systemic etiological screening process and diagnosis systems of RSA with immune type were developed, and anticardiolipin (ACL) + β_2-GP1 combining multiple assay for effective diagnosis of RSA with immune type was initially established. According to dynamic monitoring clinical parameters before and during gestation, low-dose, short-course and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA. With immune type were initiated. The outcomes of the offsprings of patients with RSA were followed up, and the safety and validity of the therapies were confirmed. The research achievement leads to great progress in the diagnosis and treatment of RSA in China.
ABSTRACT
Objective To investigate the relation between the cellular immune function and unexplained recurrent spontaneous abortion(URSA) and the mechanism of active immunotherapy on URSA patients.Methods The flow cytometry(FCM) was used to detect CD3+ ,CD4+ ,CD8+ T lymphocyte and CD16+CD56+ natural killer(NK) cell subsets and the ratio of CD4+/CD8+ of peripheral blood(PBL).112 cases with URSA(76 cases treated with active immunotherapy) and 30 cases of normal fertiled(NF) women were studied.The percentages of T lymphocyte and NK cell subsets before and after therapy were compared among 76 cases wtih URSA treated by active immunotherapy.The rate of next successful pregnancy of URSA patients treated with and without active immunotherapy was compared.Results The percentages of CD3+ and CD16+CD56+ cell subsets as well as the ratio of CD4+/CD8+ of the URSA patients were significantly higher than those of NF cases(P <0.05).After active immunotherapy,the percentages of CD3+ and CD56+CD16+ cell subsets as well as the ratio of CD4+/CD8+ of URSA cases were significantly decreased(P <0.05 ).The rate of next successful pregnancy of URSA cases with and without active immunotherapy were 88.2% and 31.2% respectively,the difference was significant(P< 0.05).Conclusion The changes in the percentages of T lympyocyte and NK cell subsets have something to do with URSA.Active immunotherapy can effectively regulate the cellular immune function and increase the rate of next successful pregnancy of URSA patients.
ABSTRACT
Objective:To investigate the effects of anti-CTLA4 antibody on Th1/Th2 shift in unexplained recurrent spontaneous abortion. Methods:The levels of IL-2,IFN-?and IL-4 were assessed by ELISA in the supernatant of cultured maternal peripheral blood mnnonuclear cells(PBMC) from 30 patients of Unexplained RSA. Cytokine synthesis was induced by activation with antigens from a chnriocarcinoma cell line of JEG-3,with anti-CTLA4 antibodv or IgG. Results:We detected significantly greater levels of the Th1 cytokines IL-2、IFN-?(P0.05). Conclusion:Anti-CTLA4 antibody can up-regulate Th1-type cytokines and down-regulate Th2-type cytokines, which indicates that in URSA anti-CTLA4 antibody could swith T cell responses to Thl,and is harmful to URSA.
ABSTRACT
Recurrent spontaneous abortion (RSA),which affects 1% to 5% of women of reproductive age,is difficult to treat in the clinical setting. In the investigations of immunopathogenesis,diagnosis and treatment of RSA since the late 1980s,it was found that RSA was associated with abnormal maternal local or systemic immune response,the pathogenesis of autoimmune RSA was mainly associated with antiphosphlipid antibody (APA),while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance. Systemic etiological screening process and diagnosis systems of RSA with immune type were developed,and anticardiolipin (ACL)+? 2-GP1 combining multiple assay for effective diagnosis of RSA with immune type was initially established. According to dynamic monitoring clinical parameters before and during gestation,low-dose,short-course and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA with immune type were initiated. The outcomes of the offsprings of patients with RSA were followed up,and the safety and validity of the therapies were confirmed. The research achievement leads to great progress in the diagnosis and treatment of RSA in China.