Immunotherapy for Recurrent Spontaneous Abortion

Coulam, Carolyn B.

doi:10.1007/978-1-4613-8422-9_19

Cited by 11 publications

(9 citation statements)

References 32 publications

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“…We therefore propose to use the rat embryo culture system, and especially the yolk sac, as a possible clinical diagnostic tool to elucidate the women with habitual abortions in which the etiology may be immonological rejection of the embryo. 25…”

Section: Discussionmentioning

confidence: 99%

Teratogenic IgG From Sera of Women With Spontaneous Abortions Seem to Induce Anomalies and Yolk Sac Damage in Rat Embryos. A Possible Method to Detect Abortions of Immunologic Origin

Abir

Ornoy

1996

American J Rep Immunol

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Section: Discussionmentioning

confidence: 99%

Teratogenic IgG From Sera of Women With Spontaneous Abortions Seem to Induce Anomalies and Yolk Sac Damage in Rat Embryos. A Possible Method to Detect Abortions of Immunologic Origin

Abir

Ornoy

1996

American J Rep Immunol

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“…Here we use flow cytometry of non‐pregnant endometrium to study intracellular and cell surface expression of CD69 in women with normal obstetric history and in women suffering from recurrent spontaneous abortions (RSA). As leukocyte immunotherapy is widely used as an effective treatment of RSA 12–14 we also investigate modulation of CD3 + CD69 + cells in response to immunotherapy.…”

Section: Introductionmentioning

confidence: 99%

Intracellular Expression of CD69 in Endometrial and Peripheral T cells Represents a Useful Marker in Women with Recurrent Miscarriage: Modulation After Allogeneic Leukocyte Immunotherapy

Ramhorst

García

Agriello

et al. 2003

American J Rep Immunol

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“…In another study, the prevalence of a 14 base pair insertion in exon 8 of the HLA-G gene was found to be increased significantly in secondary RM patients, compared with controls. These studies provide evidence that particular HLA polymorphisms characterize secondary RM [5][6][7].Huge heterogeneity between eight randomized placebocontrolled trials of IVIg to patients with RM has been observed, with live birth rates in placebo groups ranging from 29 to 79% [8][9][10][11][12][13][14][15]. The differences in live birth rates observed between these studies raises questions as to whether the patient categories are the same.…”

mentioning

confidence: 99%

“…Huge heterogeneity between eight randomized placebocontrolled trials of IVIg to patients with RM has been observed, with live birth rates in placebo groups ranging from 29 to 79% [8][9][10][11][12][13][14][15]. The differences in live birth rates observed between these studies raises questions as to whether the patient categories are the same.…”

mentioning

confidence: 99%

Advances of intravenous immunoglobulin G in modulation of anti-fetal immunity in selected at-risk populations: science and therapeutics

Christiansen

2014

Clin Exp Immunol

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Recurrent miscarriage (RM) is the occurrence of three or more consecutive miscarriages before gestational week 20 and is a condition that affects 1-3% of women [1]. RM can be classified into two categories: primary RM (no prior live birth) or secondary RM (three or more consecutive miscarriages following a live birth). In addition to genetic and anatomical factors causing RM, many studies have suggested that signs of autoimmunity and dysregulation of natural killer (NK) cell immunity characterize women with RM.Approximately 25 years ago, the first pilot studies on the use of intravenous immunoglobulin (IVIg) for the treatment of RM were conducted and reported a live birth rate of 80-82% [2,3], which provided support to warrant further investigation in placebo-controlled trials. In 2006, a Cochrane review of IVIg treatment for RM in eight placebo-controlled trials with 303 RM patients was conducted, concluding that IVIg did not increase live birth rates when compared to placebo [odds ratio (OR) = 0·98; 95% confidence interval (CI) = 0·61-1·58] [4]. However, this review did not differentiate between primary and secondary RM patients. Separate analysis of these two subsets of RM patients may be necessary, as several studies have observed that secondary RM is a condition dominated by immunological risk factors when compared to primary RM, suggesting large heterogeneity between these two subgroups.Tumour necrosis factor (TNF)-α is a cytokine involved in the immune system's inflammatory response. Piosik et al. analysed peripheral blood samples of RM patients taken at gestational week 5, and found that TNF-α levels were increased significantly in secondary RM patients compared to primary RM patients (P = 0·042) [1]. This indicates that secondary RM is a condition with an increased proinflammatory response in early pregnancy.More evidence of the role of immunological factors in secondary RM has been reported in studies that have shown associations between secondary RM patients with specific maternal human leucocyte antigen (HLA) polymorphisms. Kruse et al. found that there was a significantly higher prevalence of the HLA-DRB1*03 allele in secondary RM patients compared with controls (OR = 1·8; 95% CI = 1·3-2·5) [5], whereas the allele was not increased in patients with primary RM. A previous pregnancy with a boy can be a risk factor for secondary RM. In general, maternal immune recognition of male-specific minor histocompatibility (HY) antigens expressed in male fetal and trophoblast cells is well tolerated, resulting in a live birth. However, pregnancy with a boy may prime the mother's HY immunity. Nielsen et al. found that maternal carriage of HLA class II alleles that restrict anti-HY antigen responses reduces the chances of a live birth in secondary RM patients with a firstborn boy compared with a firstborn girl (OR = 0·17; 95% CI = 0·1-0·4; P = 0·0001) [6]. In another study, the prevalence of a 14 base pair insertion in exon 8 of the HLA-G gene was found to be increased significantly in secondary RM patients, compa...

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Immunotherapy for Recurrent Spontaneous Abortion

Cited by 11 publications

References 32 publications

Teratogenic IgG From Sera of Women With Spontaneous Abortions Seem to Induce Anomalies and Yolk Sac Damage in Rat Embryos. A Possible Method to Detect Abortions of Immunologic Origin

Teratogenic IgG From Sera of Women With Spontaneous Abortions Seem to Induce Anomalies and Yolk Sac Damage in Rat Embryos. A Possible Method to Detect Abortions of Immunologic Origin

Intracellular Expression of CD69 in Endometrial and Peripheral T cells Represents a Useful Marker in Women with Recurrent Miscarriage: Modulation After Allogeneic Leukocyte Immunotherapy

Advances of intravenous immunoglobulin G in modulation of anti-fetal immunity in selected at-risk populations: science and therapeutics

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