Roussev Roumen G, Acacio Brian, Ng Siu C, Coulam Carolyn B
Millenova Immunology Laboratories, Chicago, IL, USA.
Am J Reprod Immunol. 2008 Sep;60(3):258-63. doi: 10.1111/j.1600-0897.2008.00621.x.
In vitro investigations have revealed the ability of intralipids to suppress natural killer (NK) cytotoxicity. Evidence from both animal and human studies suggests that intralipid administered intravenously may enhance implantation and maintenance of pregnancy when the patient has an abnormal NK cell level or function.
The aim of this study was to establish the duration and efficacy of Intralipids suppressive effect on NK cell functional activity.
Fifty patients with abnormal NK activity results (NKa) received intralipid 20% i.v. (9 mg/mL total blood volume -corresponds to 2 mL of intralipid 20% diluted in 250 mL saline; or 18 mg/mL - corresponds to 4 mL of intralipid 20% diluted in 250 mL saline) infusions and their NKa were tested periodically. The determination of NK cell function was performed by flow cytometry using K562 cells as targets.
Fifty women with abnormal NKa-testing received intralipid infusions. 39 (78%) showed NKa suppression within the normal range the first week after infusion, 11 (22%), showed suppression, but still above the normal threshold. They received second infusion 2-3 weeks later. In 10, the Nka activity was normalized the following week. Four patients had three intralipid infusions in 2-week periods in between and after the third infusion, and all showed NKa normal activity. In 47 patients the suppressive effect of the Intralipid after the normalization of NKa lasted between 6 and 9 weeks, in two patients this benefit lasted 5 weeks, and in one patient the effect was 4 weeks.
Intralipid is effective in suppressing in vivo abnormal NK-cell functional activity. The results suggest that Intralipid can be used successfully as a therapeutic option to modulate abnormal NK activity in women with reproductive failure.
体外研究显示,脂肪乳剂具有抑制自然杀伤(NK)细胞细胞毒性的能力。动物和人体研究的证据表明,当患者NK细胞水平或功能异常时,静脉注射脂肪乳剂可能会增强妊娠的着床和维持。
本研究的目的是确定脂肪乳剂对NK细胞功能活性的抑制作用的持续时间和效果。
50例NK活性结果异常(NKa)的患者接受了静脉注射20%脂肪乳剂(全血容量9mg/mL - 相当于2mL 20%脂肪乳剂稀释于250mL生理盐水中;或18mg/mL - 相当于4mL 20%脂肪乳剂稀释于250mL生理盐水中)输注,并定期检测其NKa。采用流式细胞术,以K562细胞为靶细胞,测定NK细胞功能。
50例NKa检测异常的女性接受了脂肪乳剂输注。39例(78%)在输注后第一周内NKa抑制在正常范围内,11例(22%)显示有抑制作用,但仍高于正常阈值。他们在2 - 3周后接受了第二次输注。10例患者在接下来的一周内Nka活性恢复正常。4例患者在第三次输注前后的2周内分三次输注脂肪乳剂,所有患者NKa活性均恢复正常。47例患者NKa恢复正常后,脂肪乳剂的抑制作用持续6至9周,2例患者这种益处持续5周,1例患者效果持续4周。
脂肪乳剂可有效抑制体内异常NK细胞功能活性。结果表明,脂肪乳剂可成功用作调节生殖功能衰竭女性异常NK活性的治疗选择。