Agrawal S, Kishore R, Halder A, Sharma A, Sharma R K, Das V, Shukla B R, Agarwal S S
Department of Medical Genetics, Sanjay Gandhi Post Graduate Institute, Lucknow, India.
Hum Reprod. 1995 Sep;10(9):2280-4. doi: 10.1093/oxfordjournals.humrep.a136285.
The efficacy of immunotherapy in the prevention of habitual abortion remains controversial. It has been suggested that the benefits are predominantly due to psychological factors. We have evaluated the success of pregnancy outcome following immunotherapy with allogeneic lymphocytes, in relation to the subsequent development of anti-paternal cytotoxic antibodies (APCA). It was observed that in women who developed an APCA titre of > or = 1:16, live births occurred in 16 out of 21 cases (76%), while only two out of seven (28%) women who failed to achieve an APCA titre of > or = 1:16 had successful pregnancies (P < 0.05). In eight women who had an APCA titre of 1:16 on initial screening, and were, therefore, excluded from the trial, successful pregnancy outcome was noted in 62.5% of cases. Although these results are based on a small sample and on an open, non-randomized trial, they show that the efficacy of immunotherapy is related to immune response to allogeneic lymphocytes, and is not simply a placebo effect. Measurement of APCA titre could serve as a marker for immunopotentiation.
免疫疗法在预防习惯性流产方面的疗效仍存在争议。有人认为其益处主要归因于心理因素。我们评估了同种异体淋巴细胞免疫治疗后妊娠结局的成功率，并将其与抗父系细胞毒性抗体（APCA）的后续发展情况相关联。结果观察到，APCA滴度≥1:16的女性中，21例中有16例（76%）成功分娩活婴，而7例未能达到APCA滴度≥1:16的女性中只有2例（28%）妊娠成功（P<0.05）。在最初筛查时APCA滴度为1:16、因此被排除在试验之外的8名女性中，62.5%的病例妊娠结局成功。尽管这些结果基于小样本且是开放的、非随机试验，但它们表明免疫疗法的疗效与对同种异体淋巴细胞的免疫反应有关，并非仅仅是安慰剂效应。APCA滴度的测定可作为免疫增强的标志物。
