@2024 Afarand., IRAN
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2018;2(1):19-23
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2018;2(1):19-23
Evaluations of WBC Cross-match Results after Lymphocyte Immunization in Women with Recurrent Spontaneous Abortion in Sarem Women’s Hospital
ARTICLE INFO
Article Type
Original ResearchAuthors
Saremi A.T. (1)Sanaye Naderi M. (2)
Pooladi A. (1)
Younesi B. (3)
Lashgari P. (3)
Zare A. (*)
(*) “Sarem Fertility & Infertility Research Center (SAFIR)” and “Sarem Cell Research Center (SCRC)” , Sarem Women’s Hospital, Tehran, Iran
(1) “Sarem Fertility & Infertility Research Center (SAFIR)” and “Sarem Cell Research Center (SCRC)” , Sarem Women’s Hospital, Tehran, Iran
(2) Sarem Fertility & Infertility Research Center (SAFIR), Sarem Women’s Hospital, Tehran, Iran
(3) Sarem Fertility & Infertility Research Center (SAFIR), Sarem Women’s Hospital, Tehran, Iran
Correspondence
Article History
Received: August 21, 2016Accepted: December 24, 2016
ePublished: February 15, 2018
ABSTRACT
Aims
Recurrent spontaneous abortion (RSA) is a complication in pregnancy that can results in fetus rejection by mother. Lymphocyte therapy is considered as a treatment method for such patients. Leukocyte cross-match test is a method to evaluate the outcomes of lymphocyte therapy. The objective of this study was to evaluate the leukocyte cross-match results after lymphocyte immunization in women with RSA.
Materials & Methods This descriptive and cross-sectional study was conducted on 704 volunteer subjects with RSA history referred to Sarem women’s hospital (Tehran, Iran) from 2009 to 2013. The peripheral blood mononuclear cells (PBMCs) were isolated from their husband or a third donor and were injected into the patients, two or three times. Two weeks after the last immunization, the patients’ sera were tested for anti-paternal cytotoxic antibodies (APCAs) by leukocyte cross-match test. The leukocyte cross-match percentages were considered as positive if its values were more than 35% and vice versa.
Findings A positive result of leukocyte cross-match test was found in 319 (45.31%) patients with RSA that received paternal PBMCs two times. Immunization was repeated for the patients with negative tests using paternal or third donor PBMCs and positive result were observed in 219 (31.11%) patients. Totally, positive results were found in 538 (76.42%) patients.
Conclusion Lymphocyte therapy can enhances the production of APCAs in patients with RSA. It can increase the possibility of positive cross match test in these patients when it is repeated for three times.
Materials & Methods This descriptive and cross-sectional study was conducted on 704 volunteer subjects with RSA history referred to Sarem women’s hospital (Tehran, Iran) from 2009 to 2013. The peripheral blood mononuclear cells (PBMCs) were isolated from their husband or a third donor and were injected into the patients, two or three times. Two weeks after the last immunization, the patients’ sera were tested for anti-paternal cytotoxic antibodies (APCAs) by leukocyte cross-match test. The leukocyte cross-match percentages were considered as positive if its values were more than 35% and vice versa.
Findings A positive result of leukocyte cross-match test was found in 319 (45.31%) patients with RSA that received paternal PBMCs two times. Immunization was repeated for the patients with negative tests using paternal or third donor PBMCs and positive result were observed in 219 (31.11%) patients. Totally, positive results were found in 538 (76.42%) patients.
Conclusion Lymphocyte therapy can enhances the production of APCAs in patients with RSA. It can increase the possibility of positive cross match test in these patients when it is repeated for three times.
CITATION LINKS
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[2]Toth B, Jeschke U, Rogenhofer N, Scholz C, Wurfel W, Thaler CJ, et al. Recurrent miscarriage: Current concepts in diagnosis and treatment. J Reprod Immunol. 2010;85(1):25-32.
[3]Saito S. The causes and treatment of recurrent pregnancy loss. J Jpn Med Assoc.
[4]Ito K, Tanaka T, Tsutsumi N, Obata F, Kashiwagi N. Possible mechanisms of immunotherapy for maintaining pregnancy in recurrent spontaneous aborters: Analysis of anti-idiotypic antibodies directed against autologous T-cell receptors. Hum Reprod. 1999;14(3):650-5.
[5]Pandey MK, Agrawal S. Induction of MLR-Bf and protection of fetal loss: A current double blind randomized trial of paternal lymphocyte immunization for women with recurrent spontaneous abortion. Int Immunopharmacol. 2004;4(2):289-98.
[6]Pandey MK, Thakur S, Agrawal S. Lymphocyte immunotherapy and its probable mechanism in the maintenance of pregnancy in women with recurrent spontaneous abortion. Arch Gynecol Obstet. 2004;269(3):161-72.
[7]Takeshita T. Diagnosis and treatment of recurrent miscarriage associated with immunologic disorders: Is paternal lymphocyte immunization a relic of the past?. J Nippon Med Sch. 2004;71(5):308-13.
[8]Khonina NA, Broitman EV, Shevela EY, Pasman NM, Chernykh ER. Mixed lymphocyte reaction blocking factors (MLR-Bf) as potential biomarker for indication and efficacy of paternal lymphocyte immunization in recurrent spontaneous abortion. Arch Gynecol Obstet. 2013;288(4):933-7.
[9]King K, Smith S, Chapman M, Sacks G. Detailed analysis of peripheral blood natural killer (NK) cells in women with recurrent miscarriage. Hum Reprod. 2010;25(1):52-8.
[10]Quenby S, Farquharson R. Uterine natural killer cells, implantation failure and recurrent miscarriage. Reprod Biomed Online. 2006;13(1):24-8.
[11]Saito S, Nakashima A, Shima T, Ito M. Th1/Th2/Th17 and regulatory T-cell paradigm in pregnancy. Am J Reprod Immunol. 2010;63(6):601-10.
[12]Tang AW, Alfirevic Z, Quenby S. Natural killer cells and pregnancy outcomes in women with recurrent miscarriage and infertility: A systematic review. Hum Reprod. 2011;26(8):1971-80.
[13]Lee SK, Kim JY, Hur SE, Kim CJ, Na BJ, Lee M, et al. An imbalance in interleukin-17-producing T and Foxp3(+) regulatory T cells in women with idiopathic recurrent pregnancy loss. Hum Reprod. 2011;26(11):2964-71.
[14]Lee SK, Kim JY, Lee M, Gilman-Sachs A, Kwak-Kim J. Th17 and regulatory T cells in women with recurrent pregnancy loss. Am J Reprod Immunol. 2012;67(4):311-8.
[15]Lim KJ, Odukoya OA, Ajjan RA, Li TC, Weetman AP, Cooke ID. The role of T-helper cytokines in human reproduction. Fertil Steril. 2000;73(1):136-42.
[16]Zenclussen AC, Fest S, Busse P, Joachim R, Klapp BF, Arck PC. Questioning the Th1/Th2 paradigm in reproduction: Peripheral levels of IL-12 are down-regulated in miscarriage patients. Am J Reprod Immunol. 2002;48(4):245-51.
[17]Liang P, Mo M, Li GG, Yin B, Cai J, Wu T, et al. Comprehensive analysis of peripheral blood lymphocytes in 76 women with recurrent miscarriage before and after lymphocyte immunotherapy. Am J Reprod Immunol. 2012;68(2):164-74.
[18]Kling C, Steinmann J, Westphal E, Magez J, Kabelitz D. Adverse effects of intradermal allogeneic lymphocyte immunotherapy: Acute reactions and role of autoimmunity. Hum Reprod. 2006;21(2):429-35.
[19]Carp HJ, Toder V, Gazit E, Orgad S, Mashiach S, Nebel L, et al. Immunization by paternal leukocytes for prevention of primary habitual abortion: Results of a matched controlled trial. Gynecol Obstet Invest. 1990;29(1):16-21.
[20]Chaichian S, Shoaee S, Saremi A, Pedar S, Firouzi F. Factors influencing success rate of leukocyte immunization and anti-paternal antibodies in spontaneous recurrent miscarriage. Am J Reprod Immunol. 2007;57(3):169-76.
[21]Umapathy S, Shankarkumar A, Ramrakhiyani V, Ghosh K. Role of anti-human lymphocyte culture cytotoxic antibodies in recurrent spontaneous pregnancy loss women. J Hum Reprod Sci. 2011; 4(1): 17–19.
[22]Mittal KK, Mickey MR, Singal DP, Terasaki PI. Serotyping for homotransplantation. 18. Refinement of microdroplet lymphocyte cytotoxicity test. Transplantation. 1968;6(8):913-27.
[23]Terasaki PI, McClelland JD. Microdroplet assay of human serum cytotoxins. Nature. 1964;204:998-1000.
[24]Shreeve N, Sadek K. Intralipid therapy for recurrent implantation failure: New hope or false dawn?. J Reprod Immunol. 2012;93(1):38-40.
[25]Moraru M, Carbone J, Alecsandru D, Castillo-Rama M, Garcia-Segovia A, Gil J, et al. Intravenous immunoglobulin treatment increased live birth rate in a Spanish cohort of women with recurrent reproductive failure and expanded CD56(+) cells. Am J Reprod Immunol. 2012;68(1):75-84.
[26]Zare A, Saremi A, Hajhashemi M, Kardar GA, Moazzeni SM, Pourpak Z, et al. Correlation between serum zinc levels and successful immunotherapy in recurrent spontaneous abortion patients. J Hum Reprod Sci. 2013;6(2): 147–51.
[2]Toth B, Jeschke U, Rogenhofer N, Scholz C, Wurfel W, Thaler CJ, et al. Recurrent miscarriage: Current concepts in diagnosis and treatment. J Reprod Immunol. 2010;85(1):25-32.
[3]Saito S. The causes and treatment of recurrent pregnancy loss. J Jpn Med Assoc.
[4]Ito K, Tanaka T, Tsutsumi N, Obata F, Kashiwagi N. Possible mechanisms of immunotherapy for maintaining pregnancy in recurrent spontaneous aborters: Analysis of anti-idiotypic antibodies directed against autologous T-cell receptors. Hum Reprod. 1999;14(3):650-5.
[5]Pandey MK, Agrawal S. Induction of MLR-Bf and protection of fetal loss: A current double blind randomized trial of paternal lymphocyte immunization for women with recurrent spontaneous abortion. Int Immunopharmacol. 2004;4(2):289-98.
[6]Pandey MK, Thakur S, Agrawal S. Lymphocyte immunotherapy and its probable mechanism in the maintenance of pregnancy in women with recurrent spontaneous abortion. Arch Gynecol Obstet. 2004;269(3):161-72.
[7]Takeshita T. Diagnosis and treatment of recurrent miscarriage associated with immunologic disorders: Is paternal lymphocyte immunization a relic of the past?. J Nippon Med Sch. 2004;71(5):308-13.
[8]Khonina NA, Broitman EV, Shevela EY, Pasman NM, Chernykh ER. Mixed lymphocyte reaction blocking factors (MLR-Bf) as potential biomarker for indication and efficacy of paternal lymphocyte immunization in recurrent spontaneous abortion. Arch Gynecol Obstet. 2013;288(4):933-7.
[9]King K, Smith S, Chapman M, Sacks G. Detailed analysis of peripheral blood natural killer (NK) cells in women with recurrent miscarriage. Hum Reprod. 2010;25(1):52-8.
[10]Quenby S, Farquharson R. Uterine natural killer cells, implantation failure and recurrent miscarriage. Reprod Biomed Online. 2006;13(1):24-8.
[11]Saito S, Nakashima A, Shima T, Ito M. Th1/Th2/Th17 and regulatory T-cell paradigm in pregnancy. Am J Reprod Immunol. 2010;63(6):601-10.
[12]Tang AW, Alfirevic Z, Quenby S. Natural killer cells and pregnancy outcomes in women with recurrent miscarriage and infertility: A systematic review. Hum Reprod. 2011;26(8):1971-80.
[13]Lee SK, Kim JY, Hur SE, Kim CJ, Na BJ, Lee M, et al. An imbalance in interleukin-17-producing T and Foxp3(+) regulatory T cells in women with idiopathic recurrent pregnancy loss. Hum Reprod. 2011;26(11):2964-71.
[14]Lee SK, Kim JY, Lee M, Gilman-Sachs A, Kwak-Kim J. Th17 and regulatory T cells in women with recurrent pregnancy loss. Am J Reprod Immunol. 2012;67(4):311-8.
[15]Lim KJ, Odukoya OA, Ajjan RA, Li TC, Weetman AP, Cooke ID. The role of T-helper cytokines in human reproduction. Fertil Steril. 2000;73(1):136-42.
[16]Zenclussen AC, Fest S, Busse P, Joachim R, Klapp BF, Arck PC. Questioning the Th1/Th2 paradigm in reproduction: Peripheral levels of IL-12 are down-regulated in miscarriage patients. Am J Reprod Immunol. 2002;48(4):245-51.
[17]Liang P, Mo M, Li GG, Yin B, Cai J, Wu T, et al. Comprehensive analysis of peripheral blood lymphocytes in 76 women with recurrent miscarriage before and after lymphocyte immunotherapy. Am J Reprod Immunol. 2012;68(2):164-74.
[18]Kling C, Steinmann J, Westphal E, Magez J, Kabelitz D. Adverse effects of intradermal allogeneic lymphocyte immunotherapy: Acute reactions and role of autoimmunity. Hum Reprod. 2006;21(2):429-35.
[19]Carp HJ, Toder V, Gazit E, Orgad S, Mashiach S, Nebel L, et al. Immunization by paternal leukocytes for prevention of primary habitual abortion: Results of a matched controlled trial. Gynecol Obstet Invest. 1990;29(1):16-21.
[20]Chaichian S, Shoaee S, Saremi A, Pedar S, Firouzi F. Factors influencing success rate of leukocyte immunization and anti-paternal antibodies in spontaneous recurrent miscarriage. Am J Reprod Immunol. 2007;57(3):169-76.
[21]Umapathy S, Shankarkumar A, Ramrakhiyani V, Ghosh K. Role of anti-human lymphocyte culture cytotoxic antibodies in recurrent spontaneous pregnancy loss women. J Hum Reprod Sci. 2011; 4(1): 17–19.
[22]Mittal KK, Mickey MR, Singal DP, Terasaki PI. Serotyping for homotransplantation. 18. Refinement of microdroplet lymphocyte cytotoxicity test. Transplantation. 1968;6(8):913-27.
[23]Terasaki PI, McClelland JD. Microdroplet assay of human serum cytotoxins. Nature. 1964;204:998-1000.
[24]Shreeve N, Sadek K. Intralipid therapy for recurrent implantation failure: New hope or false dawn?. J Reprod Immunol. 2012;93(1):38-40.
[25]Moraru M, Carbone J, Alecsandru D, Castillo-Rama M, Garcia-Segovia A, Gil J, et al. Intravenous immunoglobulin treatment increased live birth rate in a Spanish cohort of women with recurrent reproductive failure and expanded CD56(+) cells. Am J Reprod Immunol. 2012;68(1):75-84.
[26]Zare A, Saremi A, Hajhashemi M, Kardar GA, Moazzeni SM, Pourpak Z, et al. Correlation between serum zinc levels and successful immunotherapy in recurrent spontaneous abortion patients. J Hum Reprod Sci. 2013;6(2): 147–51.