Inflammatory Cytokines in Maternal Circulation and Placenta of Chromosomally Abnormal First Trimester Miscarriages

Calleja‐Agius, Jean; Jauniaux, Eric; Muttukrishna, Shanthi

doi:10.1155/2012/175041

Cited by 13 publications

(10 citation statements)

References 39 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Conditional ⊕⊕○○Measurement of anti-HY antibodies in women with RPL is not recommended in clinical practice (Nielsen et al , 2010). Conditional ⊕⊕○○Cytokine testing should not be used in women with RPL in clinical practice (Mueller-Eckhardt et al , 1994; Calleja-Agius et al , 2012; Lee et al , 2013). Strong ⊕⊕○○Cytokine polymorphisms should not be tested in women with RPL (Choi and Kwak-Kim, 2008; Medica et al , 2009).…”

Section: Resultsmentioning

confidence: 99%

ESHRE guideline: recurrent pregnancy loss

Bender-Atik¹,

Christiansen

Elson³

et al. 2018

Human Reproduction Open

631

499

View full text Add to dashboard Cite

STUDY QUESTION What is the recommended management of women with recurrent pregnancy loss (RPL) based on the best available evidence in the literature? SUMMARY ANSWER The guideline development group formulated 77 recommendations answering 18 key questions on investigations and treatments for RPL, and on how care should be organized. WHAT IS KNOWN ALREADY A previous guideline for the investigation and medical treatment of recurrent miscarriage was published in 2006 and is in need of an update. STUDY DESIGN, SIZE, DURATION The guideline was developed according to the structured methodology for development of ESHRE guidelines. After formulation of key questions by a group of experts, literature searches and assessments were performed. Papers published up to 31 March 2017 and written in English were included. Cumulative live birth rate, live birth rate and pregnancy loss rate (or miscarriage rate) were considered the critical outcomes. PARTICIPANTS/MATERIALS, SETTING, METHODS Based on the collected evidence, recommendations were formulated and discussed until consensus was reached within the guideline group. A stakeholder review was organized after finalization of the draft. The final version was approved by the guideline group and the ESHRE Executive Committee. MAIN RESULTS AND THE ROLE OF CHANCE The guideline provides 38 recommendations on risk factors, prevention and investigations in couples with RPL, and 39 recommendations on treatments. These include 60 evidence-based recommendations – of which 31 were formulated as strong recommendations and 29 as conditional – and 17 good practice points. The evidence supporting investigations and treatment of couples with RPL is limited and of moderate quality. Of the evidence-based recommendations, only 10 (16.3%) were supported by moderate quality evidence. The remaining recommendations were supported by low (35 recommendations: 57.4%), or very low quality evidence (16 recommendations: 26.2%). There were no recommendations based on high quality evidence. Owing to the lack of evidence-based investigations and treatments in RPL care, the guideline also clearly mentions investigations and treatments that should not be used for couples with RPL. LIMITATIONS, REASONS FOR CAUTION Several investigations and treatments are offered to couples with RPL, but most of them are not well studied. For most of these investigations and treatments, a recommendation against the intervention or treatment was formulated based on insufficient evidence. Future studies may require these recommendations to be revised. WIDER IMPLICATIONS OF THE FINDINGS The guideline provides clinicians with clear advice on best practice in RPL, based on the best evidence available. In addition, a list of research recommendations is provided to stimulate further studies in RPL. One of the most important consequences of the limited evidence is the absence of evidence for a definition of RPL. STUDY FUNDING/COMPETING INTEREST(S) The guideline was developed and funded by ESHRE, covering expenses associated with the guideline meetings, with the literature searches and with the dissemination of the guideline. The guideline group members did not receive payment. J.E. reports position funding from CARE Fertility. S.L. reports position funding from SpermComet Ltd. S.M. reports research grants, consulting and speaker’s fees from GSK, BMS/Pfizer, Sanquin, Aspen, Bayer and Daiichi Sankyo. S.Q. reports speaker’s fees from Ferring. The other authors report no conflicts of interest. ESHRE Pages are not externally peer reviewed. This article has been approved by the Executive Committee of ESHRE.

show abstract

Section: Resultsmentioning

confidence: 99%

ESHRE guideline: recurrent pregnancy loss

Bender-Atik¹,

Christiansen

Elson³

et al. 2018

Human Reproduction Open

631

499

View full text Add to dashboard Cite

show abstract

“…Most of the samples assessed had undetectable levels of IL-1β, IL-6, IL-10 and CXCL8. Previously levels of IL-6, CXCL8 and IL-10 have been detected in maternal blood [21] , [23] , [35] , [36] . Key parameters differ between these studies and the current study; many looked at maternal serum [21] , [35] where as the current study examines plasma levels, this may account for the fact we cannot detect these cytokines in the current study.…”

Section: Discussionmentioning

confidence: 97%

“…IL-10, CCL2, CCL5, CCL7, CXCL8 and CX3CL1) chosen for examination in maternal blood in this study were selected because they have previously been reported to play key roles in the human endometrium [9] , [10] , [20] . In addition IL1 β, IL-6, IL-10 and CXCL8 (IL-8) have previously been examined in maternal circulation in association with miscarriage [21] – [23] .…”

Section: Introductionmentioning

confidence: 99%

A Bioplex Analysis of Cytokines and Chemokines in First Trimester Maternal Plasma to Screen for Predictors of Miscarriage

et al. 2014

View full text Add to dashboard Cite

BackgroundWe have previously shown in two independent cohorts that circulating first trimester Macrophage Inhibitory Cytokine-1 (MIC-1) levels are lower in women in early pregnancy who are destined to miscarriage. While promising, the diagnostic performance of measuring MIC-1 alone was not sufficient for it to be a useful predictive test for miscarriage. Besides MIC-1, there are other cytokines, as well as chemokines, involved in facilitating early pregnancy. We reasoned that screening these factors in maternal plasma could uncover other predictive markers of miscarriage.MethodsThis was a nested case control study, of 78 women from a prospective study of 462 attending the Early Pregnancy Assessment Unit in the first trimester (EPAU) with a threatened miscarriage; 34 of these subsequently miscarried (cases) and 44 went on to have a normal delivery (controls) Cytokines IL-1β, IL-6 and IL-10, and the chemokines, CXCL8, CCL2, CCL5, CCL7 and CX3CL1 were measured in plasma from our cohort.ResultsThe cytokines IL-1β, IL-6, IL-10 and the chemokine CXCL8 were not detectable in first trimester plasma. The chemokines CCL2, CCL5, CCL7 and CX3CL1 were detectable in all samples but levels did not vary across 5–12 weeks of gestation among controls. Plasma levels of these chemokines were no different in the miscarriage cohort compared to controls.ConclusionThe chemokines CCL2, CCL5, CCL7 and CX3CL1 were detectable in plasma during the first trimester while IL-1β, IL-6, IL-10 and CXCL8 were not. However, none of the cytokines and chemokines screened were different in maternal plasma in cases or controls. These therefore do not appear to have potential for application as predictive biomarkers of miscarriage.

show abstract

“…This lack of stratification could also explain inconsistences in the literature where some studies do not show associations. Differences in both the peripheral and local inflammatory response to normal and abnormal karyotypes have been reported (15,16). In addition to the lack of stratification, is the large degree of variation in diagnostic methodology even across a given aberration (9).…”

Section: Treating Immunologic Aspects Of Recurrent Pregnancy Lossmentioning

confidence: 99%