Research Institute of Clinical Immunology, Siberian Brunch, Russian Academy of Medical Sciences, Yadritsevskaya str., 14, Novosibirsk, 630112, Russia,
Arch Gynecol Obstet. 2013 Oct;288(4):933-7. doi: 10.1007/s00404-013-2832-x. Epub 2013 Apr 5.
The majority of cases of unexplained recurrent spontaneous abortion (RSA) remains unclear and is found to be associated with alloimmune antibodies termed as mixed lymphocyte reaction blocking factor (MLR-Bf). The decreased production of MLR-Bf may play major role in the immunologic failure of pregnancy and can lead to abortion. The present study was aimed at evaluating MLR-Bf as potential biomarker of indication and the efficacy of immunotherapy with paternal lymphocytes (LIT) in women with RSA.
A total of 97 women with history of unexplained RSA were recruited for this prospective study. These women showed negative for MLR-Bf and registered for lymphocyte immunotherapy with husband cells. Women with autoimmune pathology or anti-phospholipid syndrome were excluded. All individuals gave their consent to participate in the study.
We have analyzed MLR proliferative response and MLR-Bf in nonpregnant women with history of RSA before and after LIT. Following LIT, the initially low MLR proliferative response was restored at 76.6 % of women, and MLR-Bf activity in blood serum could be detected in 74 % of women. The rate of successful pregnancy was shown to be significantly higher in women positive for MLR-Bf (50/72) as compared with the MLR-Bf negative women (7/25; χ (2) = 0.0003).
The data obtained demonstrate that LIT with the paternal lymphocytes in MLR-Bf negative women is accompanied by increased proliferative cell response to the paternal alloantigens and by enhanced production of soluble suppressor activity factors (MLR-Bf) that is associated with improved pregnancy outcome in women with history of RSA.
大多数不明原因的复发性自然流产（RSA）仍然不清楚，并且与称为混合淋巴细胞反应阻断因子（MLR-Bf）的同种免疫抗体有关。MLR-Bf 的产生减少可能在妊娠免疫失败中起主要作用，并导致流产。本研究旨在评估 MLR-Bf 作为潜在的生物标志物，以及用父系淋巴细胞（LIT）进行免疫治疗对 RSA 妇女的疗效。
共有 97 名有不明原因 RSA 病史的妇女被招募参加这项前瞻性研究。这些妇女的 MLR-Bf 为阴性，并登记接受丈夫细胞的淋巴细胞免疫治疗。排除自身免疫性疾病或抗磷脂综合征的妇女。所有个体均同意参加研究。
我们分析了有 RSA 病史的未怀孕妇女在 LIT 前后的 MLR 增殖反应和 MLR-Bf。在 LIT 之后，最初低的 MLR 增殖反应在 76.6%的妇女中得到恢复，并且在 74%的妇女的血清中可以检测到 MLR-Bf 活性。在 MLR-Bf 阳性的妇女（50/72）中，妊娠成功率明显高于 MLR-Bf 阴性的妇女（7/25；χ²=0.0003）。
获得的数据表明，在 MLR-Bf 阴性的妇女中，用父系淋巴细胞进行 LIT 伴随着对父系同种抗原的增殖细胞反应增加，以及可溶性抑制活性因子（MLR-Bf）的产生增加，这与 RSA 病史妇女的妊娠结局改善相关。
