Department of Biomedical Sciences, Humanitas University, Milan, Italy.
Humanitas San Pio X, Milan, Italy.
Am J Reprod Immunol. 2024 Oct;92(4):e13939. doi: 10.1111/aji.13939.
Recurrent pregnancy loss (RPL) is defined as the failure of two or more pregnancies and affects approximately 5% of couples, often without a clear cause. The etiologies of RPL include factors such as maternal age, endocrine dysfunction, uterine abnormalities, chromosomal abnormalities, thrombophilias, infections, and autoimmune disorders. However, these conditions account for only 50%-60% of RPL cases. Research has explored whether an altered immune system, compared to the physiological state, may be linked to RPL. This review aims to determine whether specific immunophenotypes are associated with unexplained Recurrent Pregnancy Loss (uRPL) and whether targeted therapies addressing specific immunophenotypic alterations can improve pregnancy outcomes.
A literature review was conducted using Pubmed/Medline, Scopus, and Embase databases, analyzing data from 95 articles published between 2001 and 2023. The roles of various cells of the immune system (B lymphocytes, T lymphocytes, natural killer cells, macrophages) in different tissues (peripheral blood, menstrual blood) were specifically investigated in women with uRPL.
Specific immunophenotypes have been demonstrated to be associated with this condition. However, there is a need to standardize immunophenotyping assays and conduct more trials to stratify RPL risk and improve potential therapeutic strategies.
复发性妊娠丢失（RPL）定义为两次或更多次妊娠失败，约影响 5%的夫妇，且常无明确病因。RPL 的病因包括母体年龄、内分泌功能障碍、子宫异常、染色体异常、血栓形成倾向、感染和自身免疫性疾病等因素。然而，这些情况仅占 RPL 病例的 50%-60%。研究探索了与生理状态相比，免疫系统的改变是否与 RPL 有关。本综述旨在确定特定的免疫表型是否与不明原因的复发性妊娠丢失（uRPL）相关，以及针对特定免疫表型改变的靶向治疗是否能改善妊娠结局。
使用 Pubmed/Medline、Scopus 和 Embase 数据库进行文献回顾，分析了 2001 年至 2023 年期间发表的 95 篇文章的数据。特别研究了 uRPL 女性外周血和月经血等不同组织中各种免疫细胞（B 淋巴细胞、T 淋巴细胞、自然杀伤细胞、巨噬细胞）的作用。
已证实特定的免疫表型与这种情况相关。然而，需要标准化免疫表型检测，并进行更多试验来分层 RPL 风险，以改善潜在的治疗策略。
