Nonaka Taro, Takakuwa Koichi, Ooki Izumi, Akashi Mami, Yokoo Tomokazu, Kikuchi Akira, Tanaka Kenichi
Department of Obstetrics and Gynecology, Niigata University School of Medicine, Asahimachi-dori, Niigata, Japan.
Am J Reprod Immunol. 2007 Dec;58(6):530-6. doi: 10.1111/j.1600-0897.2007.00536.x.
The present study was conducted to examine the efficacy of immunotherapy for unexplained primary recurrent aborters using paternal lymphocytes.
Two hundred and twenty-eight recurrent aborters were prospectively followed up regarding immunotherapy. Of the 228 patients, 165 underwent immunotherapy using freshly prepared paternal lymphocytes and pregnancy outcome was analyzed. No mixed lymphocyte culture reaction-blocking antibodies (MLR-BAbs) were observed in these patients prior to vaccinations. Pregnancy outcome was also analyzed in such as those patients positive for MLR-BAbs and who did not undergo immunotherapy, and in patients negative for MLR-BAbs and who had become pregnant without immunotherapy.
Of the 140 newly pregnant patients after immunotherapy, the pregnancy continued successfully in 110 (78.6%), and the pregnancy continued successfully in 24 of 32 patients (75.0%) who were positive for MLR-BAbs. The success rate of pregnancy was 30.0% in 18 non-immunized patients. Thus, the success rate was significantly higher among patients with immunotherapy and patients positive for MLR-BAbs than in non-immunized patients, negative for MLR-BAbs.
Immunotherapy using paternal lymphocytes is considered to be effective for unexplained primary recurrent aborters negative for MLR-BAbs.
本研究旨在探讨使用父方淋巴细胞进行免疫治疗对不明原因原发性复发性流产患者的疗效。
对228例复发性流产患者进行免疫治疗的前瞻性随访。在这228例患者中，165例使用新鲜制备的父方淋巴细胞进行免疫治疗，并分析妊娠结局。这些患者在接种前未观察到混合淋巴细胞培养反应阻断抗体（MLR-BAbs）。还对MLR-BAbs阳性且未接受免疫治疗的患者，以及MLR-BAbs阴性且未接受免疫治疗而怀孕的患者的妊娠结局进行了分析。
免疫治疗后140例新怀孕患者中，110例（78.6%）妊娠成功持续；MLR-BAbs阳性的32例患者中有24例（75.0%）妊娠成功持续。18例未免疫治疗患者的妊娠成功率为30.0%。因此，接受免疫治疗的患者和MLR-BAbs阳性的患者的成功率显著高于未免疫治疗的患者和MLR-BAbs阴性的患者。
对于MLR-BAbs阴性的不明原因原发性复发性流产患者，使用父方淋巴细胞进行免疫治疗被认为是有效的。
