Toder V, Strassburger D, Carp H, Irlin I
Department of Embryology and Teratology, Tel-Aviv University Medical School, Israel.
Am J Reprod Immunol. 1991 Aug;26(1):42-6. doi: 10.1111/j.1600-0897.1991.tb00701.x.
Spontaneous abortions can be associated with preimplantation embryo loss, implantation problems and a variety of postimplantation pregnancy failures. The long list of possible causes for the postimplantation pregnancy loss includes, among others, genetic abnormalities in fetus, anatomical abnormalities of the uterus, endocrinological insufficiency, and microbiological problems. However, more than 50% of recurrent miscarriages still have no recognized causes. The concept that many such abortions may be immunologically mediated has gained increasing support over the years. Moreover, immunization of such women with husband's or third party leukocytes has resulted in more than 70% of subsequent pregnancies resulting in live births. Since neither the mechanisms leading to pregnancy loss nor the success of immunotherapy are clear, the set-up of animal models for recurrent abortions would be of supreme significance. Our recent data show that immunopotentiation of maternal immune system by Complete Freund Adjuvant significantly improves pregnancy rate in CBA x DBA/2 mouse combination with high percentage of fetal resorptions. This effect is followed by decrease of IL 2 production in spleen; increase of MAC 1-positive cells at placenta; amplification of suppressive activity of local and systemic lymphocytes and by reverse of embryotoxic effect of maternal serum. Data obtained in this model seems to be valuable in substantiation of rationale for nonspecific immunotherapy of human abortions.
自然流产可能与植入前胚胎丢失、着床问题以及多种植入后妊娠失败有关。植入后妊娠丢失的可能原因众多,其中包括胎儿的基因异常、子宫的解剖结构异常、内分泌不足以及微生物问题等。然而,超过50%的复发性流产仍原因不明。多年来,许多此类流产可能由免疫介导这一概念得到了越来越多的支持。此外,用丈夫或第三方白细胞对这类女性进行免疫治疗后,超过70%的后续妊娠可产下活婴。由于导致妊娠丢失的机制以及免疫治疗的成功原因均不明确,因此建立复发性流产的动物模型具有至关重要的意义。我们最近的数据表明,用完全弗氏佐剂增强母体免疫系统可显著提高CBA×DBA/2小鼠组合的妊娠率,该组合胎儿吸收比例较高。这种效应伴随着脾脏中白细胞介素2生成的减少;胎盘处MAC 1阳性细胞的增加;局部和全身淋巴细胞抑制活性的增强以及母体血清胚胎毒性作用的逆转。在该模型中获得的数据似乎对于证实人类流产非特异性免疫治疗的理论基础具有重要价值。