Gomaa Mostafa F, Elkhouly Abdeiiatif G, Farghly Mohammad M, Farid Laila A, Awad Nahla M
Department of Obstetrics and Gynecology, Ain Shams University, Cairo, Egypt.
Consultant Pathology, Early Cancer Detection Unit, Ain Shams University, Cairo, Egypt.
J Hum Reprod Sci. 2017 Jan-Mar;10(1):18-23. doi: 10.4103/jhrs.JHRS_65_16.
To evaluate the role of uterine natural killer (uNK) CD56 and CD16 cells in patients with refractory antiphospholipid, antibody-mediated, recurrent, pregnancy loss.
A case-control study was conducted between 2012 and 2015 at a university hospital.
A group of 118 women with a history of antiphospholipid antibody syndrome experiencing fetal loss in spite of low dose aspirin (LDA) and low molecular weight heparin (LMWH) treatment in the current pregnancy were included in this study. A group of 32 patients undergoing an elective termination of viable pregnancies before 20 weeks were taken as controls. Suction evacuation was performed to collect abortus specimens, and uterine wall curettage was performed to collect decidua specimens, which were then stained using monoclonal antibodies specific to CD56 and CD16.
Statistical analyses were performed using the Statistical Package for the Social Sciences version 18 software. Chi-square and Fisher exact tests were used for making comparison between the groups.
Abnormal fetal karyotype was found in nine (9/97) cases of the study group, which means that abnormal karyotype accounts for only 9.3% of the causes of failure of treatment. Abnormal karyotype was found in four cases of the control group. Only cases with normal karyotyping were subjected to decidual uNK cells analysis. We found that CD56 and CD16 were found in the decidua of 79 cases (79/97), which means that aberrant natural killer cells expression might account for 81.4% of the cases of refractory antiphospholipid antibody (APA)-mediated recurrent pregnancy loss.
CD56 and CD16 uNK cells might be correlated with refractory APA-mediated recurrent pregnancy loss.
评估子宫自然杀伤（uNK）细胞CD56和CD16在难治性抗磷脂抗体介导的复发性流产患者中的作用。
2012年至2015年在一所大学医院进行了一项病例对照研究。
本研究纳入了118名有抗磷脂抗体综合征病史的女性，她们在本次妊娠中尽管接受了低剂量阿司匹林（LDA）和低分子肝素（LMWH）治疗仍发生了胎儿丢失。将32名在20周前进行选择性终止活胎妊娠的患者作为对照组。通过负压吸引收集流产标本，并进行子宫壁刮宫收集蜕膜标本，然后用针对CD56和CD16的单克隆抗体进行染色。
使用社会科学统计软件包第18版软件进行统计分析。采用卡方检验和Fisher精确检验进行组间比较。
研究组97例中有9例（9/97）胎儿核型异常，这意味着核型异常仅占治疗失败原因的9.3%。对照组中有4例发现核型异常。仅对核型正常的病例进行蜕膜uNK细胞分析。我们发现79例（79/97）蜕膜中存在CD56和CD16，这意味着异常自然杀伤细胞表达可能占难治性抗磷脂抗体（APA）介导的复发性流产病例的81.4%。
CD56和CD16 uNK细胞可能与难治性APA介导的复发性流产相关。
