Zenclussen A C, Kortebani G, Mazzolli A, Margni R, Malan Borel I
Instituto de Estudios de Inmunidad Humoral (IDEHU), Universidad de Buenos Aires, Argentina.
Am J Reprod Immunol. 2000 Jul;44(1):22-9. doi: 10.1111/j.8755-8920.2000.440104.x.
Recurrent spontaneous abortion (RSA) could be interpreted as the cause for the incapacity of the mother to recognize paternal antigens to produce the desired protective response. The practise of alloimmunization was introduced in an attempt to induce in the mother the production of an alloimmune response; some authors proposed an association between cytokines and RSA. The production of IL6 and its soluble receptor (sIL6R) before and after lymphocyte immunotherapy was evaluated in sera of 33 patients suffering from two or more RSA, and in sera of 47 women with normal pregnancy.
The immunization of RSA patients was achieved by injection of four doses of 10(5) mononuclear cells (MNC) from the husband, at weekly intervals, before pregnancy. The IL6 and sIL6R levels were measured using sandwich ELISAs and the results evaluated by Tukey-Kramer multiple comparison-tests.
Our data show no significant differences between IL6 and sIL6R serum levels of normal pregnant women and RSA pregnant women with white-cell immunization before pregnancy. In contrast, the sera of pregnant RSA patients without allogeneic therapy show higher values. We also found significant differences between IL6 levels in non-pregnant RSA women with and without immunotherapy.
These results show that the alloimmunization with paternal white cells leads the serum IL6 and sIL6R-levels to the values observed in the course of normal pregnancy, suggesting a role for IL6 and sIL6R in the modulation of the immune response's quality.
复发性自然流产(RSA)可被解释为母亲无法识别父系抗原以产生所需保护反应的原因。引入同种免疫疗法是为了诱导母亲产生同种免疫反应;一些作者提出细胞因子与RSA之间存在关联。在33例有两次或更多次RSA病史的患者血清以及47例正常妊娠女性的血清中,评估了淋巴细胞免疫治疗前后白细胞介素6(IL6)及其可溶性受体(sIL6R)的产生情况。
通过在妊娠前每周注射四剂来自丈夫的10⁵个单核细胞(MNC),对RSA患者进行免疫。使用夹心酶联免疫吸附测定法(ELISA)测量IL6和sIL6R水平,并通过Tukey-Kramer多重比较检验评估结果。
我们的数据显示,正常孕妇和妊娠前接受白细胞免疫的RSA孕妇的IL6和sIL6R血清水平之间无显著差异。相比之下,未接受同种异体治疗的妊娠RSA患者血清水平较高。我们还发现接受免疫治疗和未接受免疫治疗的未孕RSA女性的IL6水平存在显著差异。
这些结果表明,用父系白细胞进行同种免疫可使血清IL6和sIL6R水平达到正常妊娠过程中观察到的值,提示IL6和sIL6R在调节免疫反应质量中发挥作用。