Sherkat Roya, Meidani Mohsen, Zarabian Hossein, Rezaei Abbas, Gholamrezaei Ali
Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
Assistant Professor, Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Med Sci. 2014 Mar;19(Suppl 1):S22-5.
Some evidence has shown a relationship between human cytomegalovirus (CMV) infection and pregnancy loss. However, whether recurrent or latent CMV infection or altered immune response to CMV is related to recurrent pregnancy loss (RPL) is unclear. We evaluated CMV infection and avidity of antibodies to CMV in women with RPL.
This case-control study was conducted on 43 women with RPL referred to a clinical immunology out-patient clinic in Isfahan (Iran), and 43 age-matched multiparous women without history of abortion as control subjects. Patients and controls were evaluated for anti-CMV IgG and IgM antibodies and IgG avidity index (AI) using the enzyme linked immunosorbent assay method. Student's t-test and Chi-square test were used to analyze the data.
One case (2.3%) of positive anti-CMV IgM was detected in each group. Anti-CMV IgG positivity was more frequent in patients than in controls (90.6% vs. 69.8%, P = 0.014), but there was no difference between the two groups in anti-CMV IgG AI (79.4 ± 11.4 vs. 80.1 ± 10.2, P = 0.781). IgG titer was significantly higher in seropositive cases with RPL than seropositive controls (5.18 ± 1.99 vs. 2.00 ± 0.81, P < 0.001).
We found that previous exposure to CMV was significantly higher in patients with RPL than the control group. However, no association was found between IgG AI and RPL. Further investigations are needed to find whether latent CMV infection starts an indirect process of autoimmune etiology in RPL or women with RPL have recurrent or reactivation of CMV infection.
一些证据表明人类巨细胞病毒（CMV）感染与妊娠丢失之间存在关联。然而，复发性或潜伏性CMV感染或对CMV的免疫反应改变是否与复发性妊娠丢失（RPL）相关尚不清楚。我们评估了RPL女性的CMV感染情况及CMV抗体亲和力。
本病例对照研究对43例转诊至伊朗伊斯法罕临床免疫门诊的RPL女性以及43例年龄匹配、无流产史的经产妇作为对照进行。采用酶联免疫吸附测定法评估患者和对照的抗CMV IgG和IgM抗体以及IgG亲和力指数（AI）。使用学生t检验和卡方检验分析数据。
每组均检测到1例（2.3%）抗CMV IgM阳性。患者中抗CMV IgG阳性率高于对照（90.6%对69.8%，P = 0.014），但两组抗CMV IgG AI无差异（79.4±11.4对80.1±10.2，P = 0.781）。RPL血清阳性病例的IgG滴度显著高于血清阳性对照（5.18±1.99对2.00±0.81，P < 0.001）。
我们发现RPL患者既往CMV暴露显著高于对照组。然而，未发现IgG AI与RPL之间存在关联。需要进一步研究以确定潜伏性CMV感染是否在RPL中启动自身免疫病因的间接过程，或者RPL女性是否存在CMV感染的复发或再激活。
