Interplay of immune components and their association with recurrent pregnancy loss

Tasadduq, Raazia; Ajmal, Laiba; Batool, Farhat; Zafar, Tehniyat; Babar, Aleena; Riasat, Amna; Shakoori, A. R.

doi:10.1016/j.humimm.2021.01.013

Cited by 8 publications

(7 citation statements)

References 74 publications

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“…There is substantial evidence that human leukocyte antigens (HLA), anti-sperm antibodies, integrins, leukemia inhibitory factor (LIF), cytokines, antiphospholipid antibodies, endometrial adhesion factors, mucin (MUC1), and uterine natural killer cells all contribute to reproductive failure ( 43 ). The development of recurrent spontaneous abortion (RSA) is also associated with immune factors ( 44 ), and immune-related RSA can be divided into two main categories: autoimmune and alloimmune types ( 45 ). The autoimmune type is mainly associated with autoimmune diseases such as antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) and associated autoantibodies.The autoantibody most closely associated with recurrent miscarriage is antiphospholipid antibodies (APA).…”

Section: Discussionmentioning

confidence: 99%

“…The autoimmune type is mainly associated with autoimmune diseases such as antiphospholipid syndrome (APS) and systemic lupus erythematosus (SLE) and associated autoantibodies.The autoantibody most closely associated with recurrent miscarriage is antiphospholipid antibodies (APA). The antibody APA may exacerbate thrombosis at the placental interface, leading to embryonic ischemic death and miscarriage ( 43 , 44 , 46 ). APA may also inhibit trophoblast function, affecting the embryonic implantation process, as well as preventing the transformation of cytotrophoblasts into syncytial trophoblasts, leaving the fetus with an inadequate supply of nutrients.…”

Section: Discussionmentioning

confidence: 99%

“…In addition, CD8+ suppressor T cells, on the other hand, may promote fetal immune tolerance by suppressing the maternal immune system to reject the fetus ( 48 ); Th17/Treg cell balance is essential to maintain the homeostasis of the immune system, with Treg cells and their associated cytokines favorable to pregnancy outcome and Th17 cells and their associated cytokines unfavorable ( 45 , 49 ). Male-specific small histocompatibility (HY) antigens also cause RPL, especially secondary recurrent miscarriage (SRM) ( 44 ). Of cause, the present researches are limited with studies being small.…”

Section: Discussionmentioning

confidence: 99%

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Whole course of treatment of autoimmune progesterone dermatitis that had spontaneously resolved during pregnancy: A case report and review of the literature

et al. 2022

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Anaphylaxis due to autoimmune progesterone dermatitis is a rare but severe allergic disease in women. The clinical manifestations of APD are diverse, and a proper understanding of the disease can help even diagnose and treat it. A case of autoimmune progesterone dermatitis related in our department is reported as follows. She developed a rash with severe pruritus that was highly consistent with her menstrual cycle without any trigger 10 years ago. Laboratory tests were unremarkable. But all the symptoms disappeared during her pregnancy and resurfaced after the miscarriage. Two years ago, after a positive progesterone intradermal test confirmed the diagnosis of PH, she was given mifepristone, contraceptives(OCPs), and skin embedding treatment, and her symptoms improved.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Whole course of treatment of autoimmune progesterone dermatitis that had spontaneously resolved during pregnancy: A case report and review of the literature

et al. 2022

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“…In China, termination of pregnancy at less than 28 weeks of gestation with a foetus weighing less than 1,000 g is still defined as miscarriage ( Writing Group Of Chinese Expert, 2020 ), and ESHRE defines miscarriage as pregnancy loss before 24 weeks of gestation ( Bender et al, 2018 ). The maintenance and progression of pregnancy is a complex process governed by multiple developmental factors ( Tasadduq et al, 2021 ). Pregnancy is associated with mechanisms that regulate the immune response at the maternal-fetal interface, and when pregnancy is combined with autoimmune abnormalities, the recurrence of autoimmune disease in some patients is associated with a significant incidence of adverse pregnancy outcomes ( Ford and Schust, 2009 ; Robinson, 2014 ).…”

Section: Introductionmentioning

confidence: 99%

Risk prediction model based on machine learning for predicting miscarriage among pregnant patients with immune abnormalities

Wu,

Yu,

et al. 2024

Front. Pharmacol.

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Introduction: It is known that patients with immune-abnormal co-pregnancies are at a higher risk of adverse pregnancy outcomes. Traditional pregnancy risk management systems have poor prediction abilities for adverse pregnancy outcomes in such patients, with many limitations in clinical application. In this study, we will use machine learning to screen high-risk factors for miscarriage and develop a miscarriage risk prediction model for patients with immune-abnormal pregnancies. This model aims to provide an adjunctive tool for the clinical identification of patients at high risk of miscarriage and to allow for active intervention to reduce adverse pregnancy outcomes.Methods: Patients with immune-abnormal pregnancies attending Sichuan Provincial People’s Hospital were collected through electronic medical records (EMR). The data were divided into a training set and a test set in an 8:2 ratio. Comparisons were made to evaluate the performance of traditional pregnancy risk assessment tools for clinical applications. This analysis involved assessing the cost-benefit of clinical treatment, evaluating the model's performance, and determining its economic value. Data sampling methods, feature screening, and machine learning algorithms were utilized to develop predictive models. These models were internally validated using 10-fold cross-validation for the training set and externally validated using bootstrapping for the test set. Model performance was assessed by the area under the characteristic curve (AUC). Based on the best parameters, a predictive model for miscarriage risk was developed, and the SHapley additive expansion (SHAP) method was used to assess the best model feature contribution.Results: A total of 565 patients were included in this study on machine learning-based models for predicting the risk of miscarriage in patients with immune-abnormal pregnancies. Twenty-eight risk warning models were developed, and the predictive model constructed using XGBoost demonstrated the best performance with an AUC of 0.9209. The SHAP analysis of the best model highlighted the total number of medications, as well as the use of aspirin and low molecular weight heparin, as significant influencing factors. The implementation of the pregnancy risk scoring rules resulted in accuracy, precision, and F1 scores of 0.3009, 0.1663, and 0.2852, respectively. The economic evaluation showed a saving of ¥7,485,865.7 due to the model.Conclusion: The predictive model developed in this study performed well in estimating the risk of miscarriage in patients with immune-abnormal pregnancies. The findings of the model interpretation identified the total number of medications and the use of other medications during pregnancy as key factors in the early warning model for miscarriage risk. This provides an important basis for early risk assessment and intervention in immune-abnormal pregnancies. The predictive model developed in this study demonstrated better risk prediction performance than the Pregnancy Risk Management System (PRMS) and also demonstrated economic value. Therefore, miscarriage risk prediction in patients with immune-abnormal pregnancies may be the most cost-effective management method.

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“…The hypothesis that the loss of pregnancy is associated with immunoreactions similar to those observed following an allograft encouraged us to identify the autoimmune etiology of miscarriage (Tasadduq et al 2021 ). As the production of antineutrophil cytoplasmic antibodies (ANCA) may be induced by the release of NETs, we decided to assess the levels of anti-proteinase 3 (anti-PR3) and anti-myeloperoxidase (anti-MPO) antibodies, which are cytoplasmic and perinuclear ANCA, respectively (Fu et al 2020 ).…”

Section: Introductionmentioning

confidence: 99%

Bisphenol A: Potential Factor of Miscarriage in Women in the Context of the Phenomenon of Neutrophil Extracellular Traps

Omeljaniuk

Charkiewicz

Garley

et al. 2022

Arch. Immunol. Ther. Exp.

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Humans are exposed to a number of environmental pollutants every day. Among them, endocrine disruptors are particularly harmful to human health. Bisphenol A (BPA) is a xenoestrogen that has been shown to disrupt the endocrine system and cause reproductive toxicity. In this study, we aimed to verify the potential relationship between BPA and miscarriage involving the formation of neutrophil extracellular traps (NETs). Blood samples were collected from healthy women and women who had miscarriage in the first trimester of pregnancy. The serum levels of cytoplasmic anti-PR3 antibody and perinuclear anti-MPO antibody were determined using an immunoenzymatic method. The concentrations of key proinflammatory proteins TNF-α and MCP-1, as well as NADPH oxidase subunits NOX1 and NCF2, were also measured in the serum samples. The serum concentration of BPA was determined using gas chromatography. The results showed that the concentrations of BPA were significantly elevated in the serum of women who had miscarriage compared to the control group, with the highest concentration found in the “NETs-positive” group. The levels of MCP-1 and TNF-α were significantly higher in the “NETs-positive” group compared to the “NETs-negative” and control group. The levels of NOX1 and NCF2 were also higher in the “NETs-positive” group compared to the “NETs-negative” group. The study showed that BPA could play a role in the course of miscarriage through the formation of NETs. The results indicate the need to limit the exposure of women planning pregnancy to xenoestrogens, including BPA.

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Interplay of immune components and their association with recurrent pregnancy loss

Cited by 8 publications

References 74 publications

Whole course of treatment of autoimmune progesterone dermatitis that had spontaneously resolved during pregnancy: A case report and review of the literature

Whole course of treatment of autoimmune progesterone dermatitis that had spontaneously resolved during pregnancy: A case report and review of the literature

Risk prediction model based on machine learning for predicting miscarriage among pregnant patients with immune abnormalities

Bisphenol A: Potential Factor of Miscarriage in Women in the Context of the Phenomenon of Neutrophil Extracellular Traps

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