Quenby Siobhan, Kalumbi Chimwemwe, Bates Michelle, Farquharson Roy, Vince Gill
School of Reproductive and Developmental Medicine, University of Liverpool, Liverpool, United Kingdom.
Fertil Steril. 2005 Oct;84(4):980-4. doi: 10.1016/j.fertnstert.2005.05.012.
To test the hypothesis that high numbers of uterine natural killer (uNK) cells in the endometrium of women with recurrent miscarriage (RM) could be reduced with prednisolone.
A before and after study.
A tertiary referral teaching hospital.
PATIENT(S): Eighty-five women with idiopathic RM recruited from all over the UK and 18 women attending for sterilization (controls).
INTERVENTION(S): An endometrial sample was taken on day 21 +/- 2 of the menstrual cycle. Immunohistochemistry was used to identify uNK (CD56+, CD16-, CD3-). Twenty-nine women with RM and >5% uNK agreed to take 20 mg oral prednisolone daily from day 1 to 21 of their menstrual cycle, when a second biopsy was obtained and analyzed.
MAIN OUTCOME MEASURE(S): The percentage of stromal cells that were uNK. The normal range was defined using control samples as <5%.
RESULT(S): Women with RM had significantly more uNK than the controls (P=.008). Prednisolone treatment significantly reduced the number of CD56 cells in the endometrium, from a median of 14% (before) to 9% (after) (P=.0004).
CONCLUSION(S): We have demonstrated that high numbers of uNK in preimplantation endometrium of women with recurrent miscarriage can be reduced with administration of prednisolone.
验证泼尼松龙可减少复发性流产（RM）女性子宫内膜中大量子宫自然杀伤（uNK）细胞这一假说。
一项前后对照研究。
一家三级转诊教学医院。
从英国各地招募的85例特发性RM女性以及18例前来进行绝育手术的女性（对照组）。
在月经周期的第21±2天采集子宫内膜样本。采用免疫组织化学方法鉴定uNK细胞（CD56 +、CD16 -、CD3 -）。29例uNK细胞>5%的RM女性同意在月经周期的第1天至21天每天口服20 mg泼尼松龙，之后获取并分析第二次活检样本。
uNK基质细胞的百分比。以对照组样本定义正常范围为<5%。
RM女性的uNK细胞显著多于对照组（P = .008）。泼尼松龙治疗显著减少了子宫内膜中CD56细胞的数量，从中位数14%（治疗前）降至9%（治疗后）（P = .0004）。
我们已证明，给予泼尼松龙可减少复发性流产女性植入前子宫内膜中大量的uNK细胞。
