Immunology: Outcome of pregnancy in women with recurrent spontaneous abortion following immunotherapy with allogeneic lymphocytes

Abstract

The efficacy of immunotherapy in the prevention of habitual abortion remains controversial. It has been suggested that the benefits are predominantly due to psychological factors. We have evaluated the success of pregnancy outcome following immunotherapy with allogeneic lymphocytes, in relation to the subsequent development of anti-paternal cytotoxic antibodies (APCA). It was observed that in women who developed an APCA titre of > or = 1:16, live births occurred in 16 out of 21 cases (76%), while only two out of seven (28%) women who failed to achieve an APCA titre of > or = 1:16 had successful pregnancies (P < 0.05). In eight women who had an APCA titre of 1:16 on initial screening, and were, therefore, excluded from the trial, successful pregnancy outcome was noted in 62.5% of cases. Although these results are based on a small sample and on an open, non-randomized trial, they show that the efficacy of immunotherapy is related to immune response to allogeneic lymphocytes, and is not simply a placebo effect. Measurement of APCA titre could serve as a marker for immunopotentiation.

Proportional change of CD4+CD25+ regulatory T cells after lymphocyte therapy in unexplained recurrent spontaneous abortion patients

“…In some other clinical investigations, it was shown that the efficacy of immunotherapy is related to the immune response by allogeneic lymphocytes and is not simply a placebo effect. Those studies suggest that allogenic lymphocytes may play an important role in maintenance of pregnancy (18,19); consistent with this, our results also suggest high clinical efficacy of alloimmunization. We know that paternal lymphocytes have a better human lymphocyte antigen (HLA) paternal blockage.…”

Induction of MLR-Bf and protection of fetal loss: a current double blind randomized trial of paternal lymphocyte immunization for women with recurrent spontaneous abortion

“…Some of the recent studies demonstrated that PL immunotherapy significantly reduced the overactivity of NK cells and Th-1 pattern of cytokines in women with RSA [46][47][48]. However, our earlier studies have shown that the efficacy of lymphocyte immunotherapy was related to immune response to allogenic lymphocytes [17,24]. We further demonstrated that MLR-Bf developed during pregnancy and alloimmunotherapy was IgG 3 in nature [26].…”

“…Alloimmunity has been indicated in several studies by showing an association of habitual abortion with an increased sharing of human leukocyte antigens (HLA) with the father that may prohibit the production of antipaternal cytotoxic antibodies (APCA), anti-idiotypic antibodies (Ab2) and mixed lymphocyte reaction blocking antibodies (MLR-Bf) in the mother. Paternal lymphocyte (PL) immunization is an effective treatment for unexplained recurrent spontaneous abortions, as it was attributed to the production of APCA [17,22,[32][33][34], Ab2 [21,35,36] and MLR-Bf [2,17,20,26,27,31,32,37 -45] during pregnancy in women with RSA. Some of the recent studies demonstrated that PL immunotherapy significantly reduced the overactivity of NK cells and Th-1 pattern of cytokines in women with RSA [46][47][48].…”

Paternal Lymphocyte Alloimmunization in the Treatment of Infertility: A New Look at an Old Problem

“…Ранние исследования показали, что дефицит указанных антител у женщин с наличием в анам-незе ПНБ или беременных с угрозой выкидыша [2,4] ассоциируется с высоким сходством партне-ров по HLA-антигенам гистосовместимости [7,17,34]. Соответственно, для профилактики и ле-чения ПНБ был предложен метод иммунизации лимфоцитами отца, позволяющий индуцировать появление БФ [2,4] , Филиппинах 12 и др., однако однозначного мнения в отношении эф-фективности данного метода так и не сложилось.…”

“…Соответственно, для профилактики и ле-чения ПНБ был предложен метод иммунизации лимфоцитами отца, позволяющий индуцировать появление БФ [2,4] , Филиппинах 12 и др., однако однозначного мнения в отношении эф-фективности данного метода так и не сложилось.…”