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探索淋巴细胞免疫疗法作为复发性流产的一种治疗方法:免疫系统调节与临床妊娠成功率的病例研究

Exploring Lymphocyte Immunotherapy as a Treatment for Recurrent Miscarriage: A Case Study of Immune System Modulation and Positive Clinical Pregnancy Rate.

作者信息

Warhade Achal D, More Akash, Anjankar Namrata, Dhamija Puja, Warhade Prajwal

机构信息

Department of Clinical Embryology, School of Allied Health Sciences, Datta Meghe Institute of Higher Education and Research, Wardha, Maharashtra, India.

Senior Embryologist, Wardha Test Tube Baby Centre (WTTBC), Acharya Vinoba Bhave Rural (AVBR) Hospitals, Sawangi (Meghe), Wardha, Maharashtra, India.

出版信息

J Pharm Bioallied Sci. 2025 May;17(Suppl 1):S994-S996. doi: 10.4103/jpbs.jpbs_387_25. Epub 2025 Apr 12.

DOI:10.4103/jpbs.jpbs_387_25
PMID:40511196
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12156657/
Abstract

This case study reviews the use of Lymphocyte Immunotherapy (LIT) in a 28-year-old female patient who had a history of recurrent first-trimester miscarriages and failed intracytoplasmic sperm injection (ICSI) cycles. She had good ovarian reserve, normal semen analysis, and negative autoimmune tests but experienced four early miscarriages, which suggested an immune-mediated issue. LIT was chosen as a treatment option to address the possibility of immune system dysregulation contributing to pregnancy loss. LIT is the process of infusing the husband's lymphocytes to promote maternal tolerance of paternal antigens, reducing the possibility of immune foetal rejection. A received LIT was performed six weeks prior to a fresh ICSI cycle, with successful fertilization and transfer of embryos. There is evidence that positive outcomes occurred in serial ultrasounds and hormone levels at 6, 8, and 12 weeks with subsequent birth at term of a healthy baby. This case points to the possibility of using LIT as a therapeutic intervention in the treatment of unexplained recurrent miscarriage in patients who had previously failed previous assisted reproductive treatments. While the mechanism of action for LIT remains unknown, it would seem to somehow modulate the immune responses so that pregnancy results in better outcomes. This case may thus provide new evidence for LIT as a possible management strategy for those with immune causes of recurrent pregnancy loss (RPL) but warrants additional studies to optimize its use and effectivity.

摘要

本病例研究回顾了淋巴细胞免疫疗法(LIT)在一名28岁女性患者中的应用,该患者有孕早期反复流产史且胞浆内单精子注射(ICSI)周期失败。她卵巢储备良好,精液分析正常,自身免疫检测呈阴性,但经历了四次早期流产,这表明存在免疫介导问题。选择LIT作为治疗方案,以解决免疫系统失调导致妊娠丢失的可能性。LIT是输注丈夫淋巴细胞以促进母体对父源抗原的耐受性、降低免疫性胎儿排斥可能性的过程。在进行新鲜ICSI周期前六周进行了LIT,胚胎成功受精并移植。有证据表明,在6周、8周和12周的系列超声检查及激素水平检测中出现了阳性结果,随后足月产下一名健康婴儿。该病例指出,对于先前辅助生殖治疗失败的不明原因反复流产患者,使用LIT作为治疗干预措施具有可能性。虽然LIT的作用机制尚不清楚,但它似乎以某种方式调节免疫反应,从而使妊娠获得更好的结果。因此,该病例可能为LIT作为复发性妊娠丢失(RPL)免疫原因患者的一种可能管理策略提供新证据,但需要更多研究来优化其使用方法和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/481a/12156657/475092febe92/JPBS-17-994-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/481a/12156657/7cd2df7f13e2/JPBS-17-994-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/481a/12156657/475092febe92/JPBS-17-994-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/481a/12156657/7cd2df7f13e2/JPBS-17-994-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/481a/12156657/475092febe92/JPBS-17-994-g002.jpg

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本文引用的文献

1
The effect of lymphocyte immunotherapy (LIT) in modulating immune responses in patients with recurrent pregnancy loss (RPL).淋巴细胞免疫疗法(LIT)在调节复发性流产(RPL)患者免疫反应中的作用。
Int Immunopharmacol. 2023 Aug;121:110326. doi: 10.1016/j.intimp.2023.110326. Epub 2023 Jun 6.
2
Efficacy of lymphocyte immunotherapy in the treatment of recurrent pregnancy loss from alloimmunity: A systematic review and meta-analysis.淋巴细胞免疫疗法治疗同种免疫性复发性流产的疗效:一项系统评价和荟萃分析。
Am J Reprod Immunol. 2022 Oct;88(4):e13605. doi: 10.1111/aji.13605. Epub 2022 Aug 2.
3
Lymphocytes immunotherapy for preserving pregnancy: Mechanisms and Challenges.
淋巴细胞免疫疗法在妊娠保护中的应用:机制与挑战。
Am J Reprod Immunol. 2018 Sep;80(3):e12853. doi: 10.1111/aji.12853. Epub 2018 Mar 31.
4
Immune response to intrapharyngeal LPS in neonatal and juvenile mice.新生和幼年小鼠对咽内脂多糖的免疫反应。
Am J Respir Cell Mol Biol. 2015 Mar;52(3):323-31. doi: 10.1165/rcmb.2014-0100OC.
5
Comprehensive analysis of peripheral blood lymphocytes in 76 women with recurrent miscarriage before and after lymphocyte immunotherapy.76 例反复自然流产患者淋巴细胞免疫治疗前后外周血淋巴细胞的综合分析。
Am J Reprod Immunol. 2012 Aug;68(2):164-74. doi: 10.1111/j.1600-0897.2012.01141.x. Epub 2012 May 11.