复发性流产中的同种免疫和自身免疫背景——静脉注射免疫球蛋白成功进行免疫治疗。
Alloimmune and autoimmune background in recurrent pregnancy loss - successful immunotherapy by intravenous immunoglobulin.
作者信息
Kotlan Beatrix, Padanyi Agnes, Batorfi Jozsef, Fulop Vilmos, Szigetvari Ivan, Rajczy Katalin, Penzes Maria, Gyodi Eva, Reti Marienne, Petranyi Gyozo
机构信息
National Medical Center, Institute of Haematology and Immunology, Budapest, Hungary.
出版信息
Am J Reprod Immunol. 2006 May;55(5):331-40. doi: 10.1111/j.1600-0897.2006.00368.x.
PROBLEM
Immunotherapies [leukocyte immunization, intravenous immunoglobulin (IVIG)] introduced to treat women with recurrent spontaneous abortions (RSA) have still controversial results in most clinical trials. A selection of these patients would be advantageous for higher efficacy.
METHOD OF STUDY
A complex immunological panel assay was offered to patients with reproductive failure without any other known cause. We focused here on the cellular immunological parameters.
RESULTS
High cytotoxic T lymphocyte precursor frequency and cell-mediated cytotoxic activity and a rather high natural killer cell activity were found in alloimmune RSA patients. Thirty-two patients were investigated by immunological assays and in 78% of the women an alloimmune background could be defined. The efficacy of IVIG treatment was 96% in this group.
CONCLUSIONS
The novel cellular immunological assays proved to be favourable for the indication of RSA patients and showed the usefulness of this selection process for effective immunotherapy.
问题
用于治疗复发性自然流产（RSA）女性的免疫疗法[白细胞免疫、静脉注射免疫球蛋白（IVIG）]在大多数临床试验中结果仍存在争议。挑选这类患者可能有利于提高疗效。
研究方法
为无其他已知病因的生殖功能衰竭患者提供了一项复杂的免疫检测。我们在此关注细胞免疫参数。
结果
在同种免疫性RSA患者中发现高细胞毒性T淋巴细胞前体频率、细胞介导的细胞毒性活性以及相当高的自然杀伤细胞活性。通过免疫检测对32例患者进行了研究，78%的女性可确定为同种免疫背景。该组IVIG治疗的有效率为96%。
结论
新的细胞免疫检测方法被证明有利于RSA患者的诊断，并表明这种筛选过程对有效的免疫治疗有用。
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