Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, Korea.
Am J Reprod Immunol. 2013 Nov;70(5):398-411. doi: 10.1111/aji.12137. Epub 2013 May 9.
Dysregulated natural killer (NK) immunity and T-cell immunity are associated with recurrent pregnancy loss (RPL). We aim to define clinically relevant NK and T-cell parameters for RPL and determine their cutoff values.
Ninety-five women with RPL (>3) including 42 idiopathic and 53 known-etiology RPL, and 29 age-matched fertile controls were enrolled. Peripheral blood immunophenotype, NK cell cytotoxicity (NKC), and T-helper (Th) 1 and Th2 cytokine producing cell ratios (Th1/Th2) were measured using flowcytometry. The cutoff values were determined using Youden's J with likelihood ratio (LR) >2.
Natural killer cell percentage and NKC, TNF-α(+) Th1 cells, and TNF-α/IL-10 producing Th1/Th2 cell ratio were significantly higher in idiopathic RPL than controls. By the area under the curve (AUC) analysis, NK cell percentage (AUC = 0.691), NKC (AUC = 0.649), TNF-α(+) Th1 cells (AUC = 0.681) and Th1/Th2 cell ratio (AUC = 0.660) were highly specific for RPL. The cutoff values for NK cell percentage, NKC (E:T cell ratio 25:1), and TNF-α/IL-10 producing Th1/Th2 cell ratio are 16.1, 23.8, and 36.2%, respectively. Seventy-six percent of idiopathic RPL showed at least one of more immune abnormalities by these criteria.
Differences in NK cell percentages, NKC and Th1/Th2 cell ratio differentiated RPL from fertile controls.
调节性自然杀伤 (NK) 免疫和 T 细胞免疫与复发性妊娠丢失 (RPL) 有关。我们旨在定义与 RPL 相关的临床相关 NK 和 T 细胞参数，并确定其临界值。
招募了 95 名 RPL (>3) 患者，包括 42 名特发性和 53 名已知病因 RPL 患者，以及 29 名年龄匹配的生育力对照组。使用流式细胞术测量外周血免疫表型、NK 细胞细胞毒性 (NKC) 和 T 辅助 (Th) 1 和 Th2 细胞因子产生细胞比 (Th1/Th2)。使用 Youden 的 J 和似然比 (LR) >2 确定临界值。
特发性 RPL 患者的 NK 细胞百分比和 NKC、TNF-α(+) Th1 细胞和 TNF-α/IL-10 产生 Th1/Th2 细胞比值均明显高于对照组。通过曲线下面积 (AUC) 分析，NK 细胞百分比 (AUC = 0.691)、NKC (AUC = 0.649)、TNF-α(+) Th1 细胞 (AUC = 0.681) 和 Th1/Th2 细胞比值 (AUC = 0.660) 对 RPL 具有高度特异性。NK 细胞百分比、NKC (E:T 细胞比值 25:1) 和 TNF-α/IL-10 产生 Th1/Th2 细胞比值的临界值分别为 16.1%、23.8%和 36.2%。根据这些标准，76%的特发性 RPL 表现出至少一种免疫异常。
NK 细胞百分比、NKC 和 Th1/Th2 细胞比值的差异将 RPL 与生育力对照组区分开来。
