Saeed Zarei, Haleh Soltanghoraee, Afsaneh Mohammadzadeh, Soheila Arefi, Amir Hassan Zarnani, Farah Idali, Banafsheh Tavangar, Elham Savadi Shiraz, Narges Moshref Behzad, Mahmood Jeddi-Tehrani
Monoclonal Antibody Research Center, Avicenna Research Institute, ACECR, Tehran, Iran.
J Reprod Infertil. 2010 Apr;11(1):47-52.
Recurrent abortion (RA) may be a consequence of aberrant expression of immunological factors during pregnancy. Although the relative importance of immunological factors in human reproduction remains controversial, substantial evidence suggests that autoantibodies contribute to reproductive failure. Production of such antibodies is under the control of cytokines; and leptin, besides its role in reproductive success, has a profound effect on directing the cytokine profile toward Th1 (cellular) pattern. Therefore, the present study was performed to assess serum leptin levels in women with immunological recurrent abortion.
In this prospective study, 250 women who attended Avicenna Infertility Clinic with RA were screened for known causes of abortion from July to December 2008 in Tehran, Iran. Eighty-one patients with normal karyotypes and hormonal profile with normal ovaries and uterus and no signs of infection were categorized as patients with immunological (IRA, n = 39) or unexplained (URA, n = 42) recurrent abortion based on presence or absence of autoantibodies. After blood sampling, levels of anti-nuclear antibody (ANA), anti-double stranded DNA antibody (anti-dsDNA), lupus anti-coagulant antibody (LACAb), anti-phospholipid antibody (APA), anti-cardiolipin antibody (ACA), anti-thyroglobulin antibody (TgAb), anti-thyroperoxidase antibody (TPOAb) and anti-thrombin III antibody (ATIIIAb) were measured by enzyme-linked immunosorbent assay (ELISA) or chemiluminescent enzyme immunoassay (CLEIA).
In IRA group, 9 (23.1%), 24 (61.5%), 25(64.1%) and 1 (2.6%) women were above the normal cut-off point for ANA, TgAbs, TPOAbs and AT-III Abs, respectively. IRA patients had normal values of LACAbs, APA and ACA. With normal level of fasting blood sugar (FBS), IRA and URA groups had similar serum leptin levels (23.7 ± 13.2 ng/ml vs. 22.7 ± 12.5 ng/ml, respectively). Serum leptin concentrations showed a positive correlation with weight and BMI in both groups.
This study suggests that serum leptin levels are higher in IRA and URA patients than normal women. The findings of this study suggest the need for a more comprehensive study and comparison of leptin levels in IRA and URA patients to women with no history of miscarriages.
复发性流产（RA）可能是孕期免疫因子异常表达的结果。尽管免疫因子在人类生殖中的相对重要性仍存在争议，但大量证据表明自身抗体与生殖失败有关。此类抗体的产生受细胞因子控制；而瘦素除了在生殖成功中发挥作用外，对引导细胞因子谱向Th1（细胞）模式具有深远影响。因此，本研究旨在评估免疫性复发性流产女性的血清瘦素水平。
在这项前瞻性研究中，2008年7月至12月期间，在伊朗德黑兰的阿维森纳不孕不育诊所就诊的250名患有复发性流产的女性接受了已知流产原因的筛查。81名染色体核型和激素水平正常、卵巢和子宫正常且无感染迹象的患者，根据自身抗体的有无被分类为免疫性（IRA，n = 39）或不明原因（URA，n = 42）复发性流产患者。采血后，通过酶联免疫吸附测定（ELISA）或化学发光酶免疫测定（CLEIA）测量抗核抗体（ANA）、抗双链DNA抗体（抗dsDNA）、狼疮抗凝抗体（LACAb）、抗磷脂抗体（APA）、抗心磷脂抗体（ACA）、抗甲状腺球蛋白抗体（TgAb）、抗甲状腺过氧化物酶抗体（TPOAb）和抗凝血酶III抗体（ATIIIAb）的水平。
在IRA组中，分别有9名（23.1%）、24名（61.5%）、25名（64.1%）和1名（2.6%）女性的ANA、TgAbs、TPOAbs和AT-III Abs高于正常临界值。IRA患者的LACAbs、APA和ACA值正常。在空腹血糖（FBS）水平正常的情况下，IRA组和URA组的血清瘦素水平相似（分别为23.7±13.2 ng/ml和22.7±12.5 ng/ml）。两组血清瘦素浓度均与体重和BMI呈正相关。
本研究表明，IRA和URA患者的血清瘦素水平高于正常女性。本研究结果表明，需要对IRA和URA患者与无流产史女性的瘦素水平进行更全面的研究和比较。
