Effect of levamisole as an immunomodulating agent in trophoblastic lesions.

Both cell mediated immunity and humoral immunity was assessed in 16 patients of hydatidiform mole and 6 patients of choriocarcinoma. Fifty percent patients of choriocarcinoma and 11 patients of vesicular mole were given levamisole (LVM) trial and were followed for 2 months. Absolute lymphocyte count (ALC) was significantly increased in vesicular mole after levamisole treatment but in choriocarcinoma no effect was obtained. Marked improvement of T cell rosette count was also seen in LVM treated patient of both vesicular mole (p < 0.001) and choriocarcinoma. Cutaneous DTH response to 2:4 DNCB in vesicular mole was also increased after LVM. Before treatment only 31.25% patients had strong cutaneous response but after treatment 53.35% patients had strong response, while cases of choriocarcinoma were unaffected. LVM also raised all the serum immunoglobulins (IgG, IgM, IgA) in both vesicular mole and choriocarcinoma. Hence, levamisole therapy was found to have a beneficial effect on both cellular and humoral immunity in the lesions of trophoblasts.

Circulating immune complexes in patients with complete molar pregnancy

Circulating immune complexes [CICs] were measured in 14 patients with complete molar pregnancy to investigate CICs and trophoblastic tumor burden, when 11 of the 14 patients were first seen, CICs were in the normal range. All the 3 patients with elevated levels of CICs had concurrent bilharziasis and 2 of them had preeclampsia. Patients with normal CICs, when followed up, developed increased levels when entered remission. Circulating immune complexes remained elevated during gonadotropin remission from 6 to 17 weeks and then declined to initial levels. The decreasing antigen load, when the patient approaches gonadotropin remission, may provide a more favorable antigen: antibody ratio for the formation and detection of CICs using the polyethylene glycol [PEG] turbidity assay