Lymphocyte immunotherapy in the correction of alloimmune disorders in recurrent miscarriage


Cite item

Full Text

Open Access Open Access
Restricted Access Access granted
Restricted Access Subscription or Fee Access

Abstract

The review outlines current ideas on the mechanism of sporadic recurrent abortion associated with an imbalance of immunological relationships between the maternal organism and the developing fetus, i.e. with alloimmune causes. It describes immunological markers that point to the alloimmune genesis of sporadic recurrent abortion and that are used to evaluate the eff iciency of immunomodulation during lymphocyte immunotherapy. The reasons for inconsistency in opinions on the efficiency of lymphocyte immunotherapy in treating this obstetric pathology are unveiled.

Full Text

Restricted Access

About the authors

A. M Khachatryan

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

Email: nellyl986@mail.ru
Graduate student, Department of Pregnancy Loss Prevention and Therapy

L. V Krechetova

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

Email: klv@mail.ru
Ph.D. in medical sciences, Head of Laboratory of Clinical Immunology

N. K Tetruashvili

Academician V.I. Kulakov Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health and Social Development of Russia

Email: n_tetruashvili@oparina4.ru
Doctor of Medicine, Head of the Department of Pregnancy Loss Prevention and Therapy

References

  1. Сидельникова В.М., Сухих Г.Т. Невынашивание беременности: Руководство для практикующих врачей. М.: МИА; 2011. 516 с.
  2. American College of Obstetricians and Gynecologists. ACOG practice bulletin. Management of recurrent early pregnancy loss. Int. J. Gynaecol. Obstet. 2002; 78(2): 179-90.
  3. Chong P.J., Matzner W.L., Ching W.T. Benefit of leukocyte immunizations? Fertil. Steril. 1993; 59(1): 247-9.
  4. Chong P.J., Matzner W.L., Ching W.T. Controversy about immunotherapy. Fertil. Steril. 1993; 59(5): 1138-9.
  5. Farquharson R.G., Stephenson M.D., eds. Early pregnancy. Cambridge University Press; 2012. doi: http://dx.doi.org/10.1017/CB09780511777851 Cambridge Books Online: Available at: http://ebooks.cambridge.org/
  6. Kheshtchin N., Gharagozloo M., Andalib A., Ghahiri A., Maracy M.R., Rezaei A. The expression of Th1- and Th2-related chemokine receptors in women with recurrent miscarriage: the impact of lymphocyte immunotherapy. Am. J. Reprod. Immunol. 2010; 64(2): 104-12.
  7. Clark D.A. Cell surface CD200 may predict efficacy of paternal mononuclear leukocyte immunotherapy in treatment of human recurrent pregnancy loss. Am. J. Reprod. Immunol. 2009; 61: 75-84.
  8. Посиссева Л.В., Малышкина А.И., Бойко Е.Л., Сотникова Н.Ю., Перетятко Л.П., Фетисова И.Н. Реабилитация репродуктивного здоровья супружеских пар с невынашиванием беременности. Иваново: ОАО «Изд-во «Иваново»; 2008. 240 с.
  9. Park D.W., Lee H.J., Park C.W., Hong S.R., Kwak-Kim J., Yang K.M. Peripheral blood NK cells reflect changes in decidual NK cells in women with recurrent miscarriages. Am. J. Reprod. Immunol. 2010; 63(2): 173-80.
  10. Raghupathy R. The immune system in pregnancy: Friend or foe? Kuwait Med. J. 2009; 41(2): 93-102.
  11. Williams Z. Inducing tolerance to pregnancy. N. Engl. J. Med. 2012; 367(12): 1159-61.
  12. Agrawal S., Pandey M.K., Mandai S., Mishra L., Agarwal S. Humoral immune response to an allogenic foetus in normal fertile women and recurrent aborters. BMC Pregnancy Childbirth. 2002; 2(1): 6.
  13. Zenclussen A.C. Regulatory T cells in pregnancy. Springer Semin. Immunopathol. 2006; 28: 31-9.
  14. Lee S.K., Na B.J., Kim J.Y., Hur S.E., Lee M., Gilman-Sachs A., Kwak-Kim J. Determination of clinical cellular immune markers in women with recurrent pregnancy loss. Am. J. Reprod. Immunol. 2013; 70(5): 398-411. doi: 10.1111/aji.12137.
  15. Yang H., Qiu L., Chen G., Ye Z., Lü C., Lin Q. Proportional change of CD4+CD25+ regulatory T cells in decidua and peripheral blood in unexplained recurrent spontaneous abortion patients. Fertil. Steril. 2008; 89(3): 656-61.
  16. Zenclussen A.C., Gelof K.,Zenclussen M.L.,Ritter T,Kotsch K.,Leber J., Volk H.D. Abnormal T-cell reactivity against paternal antigens in spontaneous abortion: adoptive transfer of pregnancy-induced CD4+ CD25+ T regulatory cells prevents fetal rejection in a murine abortion model. Am. J. Pathol. 2005; 166: 811-22.
  17. Shou Z., Xu Y., Xiao H., Zhou Q., Cai J., Yang Y. et al. The effect of pregnancy on paternal skin allograft survival. Sci. China C Life Sci. 2009; 52(11): 1011-5.
  18. Saito S., Sasaki Y., Sakai M. CD4+CD25+high regulatory T-cells in human pregnancy. J. Reprod. Immunol. 2005; 65(2): 111-20.
  19. Somerset D.A., Zheng Y., Kilby M.D., Sansom D.M., Drayson M.T. Normal human pregnancy is associated with an elevation in the immune suppressive CD25+ CD4+ regulatory T-cell subset. Immunology. 2004; 112(1): 38-43.
  20. Saito S., Shima T., Nakashima A., Shiozaki A., Ito M., Sasaki Y. What is the role of regulatory T cells in the success of implantation and early pregnancy? J. Assist. Reprod. Genet. 2007; 24: 379-86.
  21. Gharesi-Fard B., Zolghadri J., Kamali-Sarvestani E. Effect of leukocyte therapy on tumor necrosis factor-alpha and interferon-gamma production in patients with recurrent spontaneous abortion. Am. J. Reprod. Immunol. 2008; 59(3): 242-50.
  22. Chaouat G., Ledee-Bataille N., Dubanchet S., Zourbas S., Sandra O., Martal J. Reproductive immunology 2003: reassessing the Th1 / Th2 paradigm? Immunol. Lett. 2004; 92: 207-14.
  23. Wang W.J., Hao C.F, Lin Q.D. Dysregulation of macrophage activation by decidual regulatory T cells in unexplained recurrent miscarriage patients. J. Reprod. Immunol. 2011; 92(1-2): 97-102.
  24. Tang A.W., Alfirevic Z, Quenby S. Natural killer cells and pregnancy outcomes in women with recurrent miscarriage and infertility: a systematic review. Hum. Reprod. 2011; 26(8): 1971-80.
  25. Kuroda K., Venkatakrishnan R., James S., Sucurovic S., Mulac-Jericevic B., Lucas E.S. et al. Elevated periimplantation uterine natural killer cell density in human endometrium is associated with impaired corticosteroid signaling in decidualizing stromal cells. J. Clin. Endocrinol. Metab. 2013; 98(11): 4429-37.
  26. Vacca P., Cantoni C., Vitale M., Prato C., Canegallo F., Fenoglio D. et al. Crosstalk between decidual NK and CD14+ myelomonocytic cells results in induction of Tregs and immunosuppression. Proc. Natl. Acad. Sci. USA. 2010; 107(26): 11918-23.
  27. Trabanelli S., Ocadlikova D., Evangelisti C., Parisi S., Curti A. Induction of regulatory T cells by dendritic cells through indoleamine 2,3-dioxygenase: a potent mechanism of acquired peripheral tolerance. Curr. Med. Chem. 2011; 18(15): 2234-9.
  28. Clark D.A., Wong K., Banwatt D., Chen Z., Liu J., Lee L. et al. CD200-dependent and nonCD200-dependent pathways of NK cell suppression by human IVIG. J. Assist. Reprod. Genet. 2008; 25(2-3): 67-72.
  29. Reznikoff-Etievant M.F., Durieux I., Lobet R., Dambrosio A., Touré C., Dufraisse C. et al. Immunologic abortion and its treatment by immunotherapy. Rev. Fr. Transfus. Immunohematol. 1986; 29(3): 135-48.
  30. Beer A.E. New horizons in the diagnosis, evaluation and therapy of recurrent spontaneous abortion. Clin. Obstet. Gynaecol. 1986; 13(1): 115-24.
  31. Говалло В.И., Сидельникова В.М. Иммунизация беременных женщин аллогенными лимфоцитами мужа как метод профилактики самопроизвольных выкидышей. Акушерство и гинекология. 1983; 12: 25-7.
  32. Сухих Г.Т., Ванько Л.В. Иммунология беременности. М.: Издательство РАМН; 2003. 400 с.
  33. Carp H.J.A., ed. Recurrent pregnancy loss: causes, controversies and treatment. Informa Healthcare; 2007. 290 p.
  34. Porter T.F., LaCoursiere Y., Scott J.R. Immunotherapy for recurrent miscarriage. Cochrane Database Syst. Rev. 2006; (2): CD000112.
  35. Gharesi-Fard B., Zolghadri J., Foroughinia L., Tavazoo F., Samsami Dehaghani A. Effectiveness of leukocyte immunotherapy in primary recurrent spontaneous abortion (RSA). Iran J. Immunol. 2007; 4(3): 173-8.
  36. Hayakawa S., Karasaki-Suzuki M., Itoh T., Ishii M., Kanaeda T., Nagai N. et al. Effects of paternal lymphocyte immunization on peripheral Th1:Th2 balance and TCR Vb and Vg repertoire usage of patients with recurrent spontaneous abortions. Am. J. Reprod. Immunol. 2000; 43: 107-14.
  37. Pandey M.K., Agrawal S. 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. Int. Immunopharmacol. 2004; 4: 289-98.
  38. Takeshita T. Diagnosis and treatment of recurrent miscarriage associated with immunologic disorders: Is paternal lymphocyte immunization a relic of the past? J.Nippon Med. Sch. 2004; 71(5): 308-13.
  39. Петросян Л.А. Оптимизация лимфоцитоиммунотерапии в лечении привычной потери беременности первого триместра: Автореф. дис.. канд. мед. наук. М.; 2009. 24 с.
  40. Check J.H. A practical approach to the prevention of miscarriage: part 2--active immunotherapy. Clin. Exp. Obstet. Gynecol. 2010; 37(1): 5-9.
  41. Yang H., Qiu L., Di W., Zhao A., Chen G., Hu K., Lin Q. Proportional change of CD4+CD25+ regulatory T cells after lymphocyte therapy in unexplained recurrent spontaneous abortion patients. Fertil. Steril. 2009; 92(1): 301-5.
  42. Khonina N.A., Broitman E.V., Shevela E.Y., Pasman N.M., Chernykh E.R. Mixed lymphocyte reaction blocking factors (MLR-Bf) as potential biomarker for indication and efficacy of paternal lymphocyte immunization in recurrent spontaneous abortion. Arch. Gynecol. Obstet. 2013; 288(4): 933-7.
  43. Nonaka T., Takakuwa K., Ooki I., Akashi M., Yokoo T., Kikuchi A., Tanaka K. Results of immunotherapy for patients with unexplained primary recurrent abortions--prospective non-randomized cohort study. Am. J. Reprod. Immunol. 2007; 58(6): 530-6.
  44. Liang P., Mo M., Li G.G., Yin B., Cai J., Wu T. et al. Comprehensive analysis of peripheral blood lymphocytes in 76 women with recurrent miscarriage before and after lymphocyte immunotherapy. Am. J. Reprod. Immunol. 2012; 68(2): 164-74.
  45. Wilczyński J.R., Radwan P., Tchorzewski H., Banasik M. Immunotherapy of patients with recurrent spontaneous miscarriage and idiopathic infertility: does the immunization-dependent Th2 cytokine overbalance really matter? Arch. Immunol. Ther. Exp. (Warsz). 2012; 60(2): 151-60

Supplementary files

Supplementary Files
Action
1. JATS XML
Download

This website uses cookies

You consent to our cookies if you continue to use our website.

About Cookies