@2024 Afarand., IRAN
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2018;2(3):
ISSN: 2251-8215 Sarem Journal of Reproductive Medicine 2018;2(3):
Immunology of Recurrent Spontaneous Abortion
ARTICLE INFO
Article Type
Systematic ReviewAuthors
Roumandeh N. (1)Zare A. (*)
Saremi A.T. (2)
(*) Sarem Fertility & Infertility Research Center (SAFIR), Sarem Women’s Hospital, Tehran, Iran
(1) Sarem Cell Research Center (SCRC), Sarem Women’s Hospital, Tehran, Iran
(2) “Sarem Fertility & Infertility Research Center (SAFIR)” and “Sarem Cell Research Center (SCRC)” , Sarem Women’s Hospital, Tehran, Iran
Correspondence
Address: Sarem Women’s Hospital, Basij Square, Phase 3, Ekbatan Town, Tehran, Iran. Postal Code: 1396956111Phone: +98 (21) 44670888
Fax: +98 (21) 44670432
ahadzr@gmail.com
Article History
Received: March 5, 2017Accepted: June 25, 2017
ePublished: August 15, 2017
ABSTRACT
Instrument & Methods
Recurrent Spontaneous Abortion (RSA) is one of the most common complications in reproductive ages. Several factors such as genetic, anatomical, and endocrine disorders, infection, and environmental and immunological factors have been involved in RSA. In cases of abortions, whose reasons are known, the chance of success in pregnancy can be increased after the elimination of the defective factors; but, in women with a history RSA with an unknown reason, there is an imbalance in the regulatory mechanisms of immune cells, and even the pattern of immunological cells changes in these women. Actually, an inappropriate immune response is often associated with pregnancy loss. Immunologic factors involved in patients with RSA have gradually been identified, using diagnostic methods and several studies. The present study was conducted with the aim of reviewing RSA immunology and new findings in this field. In this study, more than 40 articles on immunologic factors involved in RSA were reviewed.
Conclusion Based on the current findings related to the immunology of pregnancy, due to the extensive role of the immunologic factors in this disorder, more accurate identification of the functional role of each immunologic factor becomes more important. Also, new therapeutic approaches will be addressed to the researchers in this field based on the changes in the function of immune system.
Conclusion Based on the current findings related to the immunology of pregnancy, due to the extensive role of the immunologic factors in this disorder, more accurate identification of the functional role of each immunologic factor becomes more important. Also, new therapeutic approaches will be addressed to the researchers in this field based on the changes in the function of immune system.
CITATION LINKS
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[23]Yue CY, Zhang B, Ying CM. Elevated serum level of IL-35 associated with the maintenance of maternal-fetal immune tolerance in normal pregnancy. Plos One. 2015;10(6):e0128219.
[2]Bao SH, Wang XP, De Lin Q, Wang WJ, Yin GJ, Qiu LH. Decidual CD4+CD25+CD127dim/- regulatory T cells in patients with unexplained recurrent spontaneous miscarriage. Eur J Obstet, Gynecol, Reprod biol. 2011;155(1):94-8.
[3]Pandey MK, Rani R, Agrawal S. An update in recurrent spontaneous abortion. Arch Gynecol Obstet. 2005;272(2):95-108.
[4]Somerset DA, Zheng Y, Kilby MD, Sansom DM, Drayson MT. Normal human pregnancy is associated with an elevation in the immune suppressive CD25+ CD4+ regulatory T-cell subset. Immunol. 2004;112(1):38-43.
[5]Fu B, Tian Z, Wei H. TH17 cells in human recurrent pregnancy loss and pre-eclampsia. Cell Mol Immunol. 2014;11(6):564-70.
[6]Xiong H, Zhou C, Qi G. Proportional changes of CD4+CD25+Foxp3+ regulatory T cells in maternal peripheral blood during pregnancy and labor atterm and preterm. Clin Invest Med Med. 2010;33(6):E422.
[7]Steinborn A, Haensch GM, Mahnke K, Schmitt E, Toermer A, Meuer S, et al. Distinct subsets of regulatory T cells during pregnancy: is the imbalance of these subsets involved in the pathogenesis of preeclampsia?. Clin Immunol. 2008;129(3):401-12.
[8]Santner Nanan B, Peek MJ, Khanam R, Richarts L, Zhu E, Fazekas de St Groth B, et al. Systemic increase in the ratio between Foxp3+ and IL-17-producing CD4+ T cells in healthy pregnancy but not in preeclampsia. J Immunol. 2009;183(11):7023-30.
[9]Wang WJ, Hao CF, Qu QL, Wang X, Qiu LH, Lin QD. The deregulation of regulatory T cells on interleukin-17-producing T helper cells in patients with unexplained early recurrent miscarriage. Hum Reprod. 2010;25(10):2591-6.
[10]Wang WJ, Hao CF, Yi L, Yin GJ, Bao SH, Qiu LH, et al. Increased prevalence of T helper 17 (Th17) cells in peripheral blood and decidua in unexplained recurrent spontaneous abortion patients. J Reprod Immunol. 2010;84(2):164-70.
[11]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.
[12]Arruvito L, Sanz M, Banham AH, Fainboim L. Expansion of CD4+CD25+and FOXP3+ regulatory T cells during the follicular phase of the menstrual cycle: Implications for human reproduction. J Immunol. 2007;178(4):2572-8.
[13]Sasaki Y, Sakai M, Miyazaki S, Higuma S, Shiozaki A, Saito S. Decidual and peripheral blood CD4+CD25+ regulatory T cells in early pregnancy subjects and spontaneous abortion cases. Mol Hum Reprod. 2004;10(5):347-53.
[14]Liu YS, Wu L, Tong XH, Wu LM, He GP, Zhou GX, et al. Study on the relationship between Th17 cells and unexplained recurrent spontaneous abortion. Am J Reprod Immunol. 2011;65(5):503-11.
[15]Piccinni MP. T cell tolerance towards the fetal allograft. J Reprod Immunol. 2010;85(1):71-5.
[16]Winger EE, Reed JL. Low circulating CD4(+) CD25(+) Foxp3(+) T regulatory cell levels predict miscarriage risk in newly pregnant women with a history of failure. Am J Reprod Immunol. 2011;66(4):320-8.
[17]Sereshki N, Gharagozloo M, Ostadi V, Ghahiri A, Roghaei MA, Mehrabian F, et al. Variations in T-helper 17 and regulatory T cells during the menstrual cycle in peripheral blood of women with recurrent spontaneous abortion. Int J fertil steril. 2014;8(1):59-66.
[18]Saini V, Arora S, Yadav A, Bhattacharjee J. Cytokines in recurrent pregnancy loss. Int J Clin Chemist. 2011;412(9-10):702-8.
[19]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.
[20]Yang H, Qiu L, Chen G, Ye Z, Lu C, Lin Q. Proportional change of CD4+CD25+ regulatory T cells in decidua and peripheral blood in unexplained recurrent spontaneous abortion patients. Fertil Steril. 2008;89(3):656-61.
[21]Mei S, Tan J, Chen H, Chen Y, Zhang J. Changes of CD4+ CD25high regulatory T cells and FOXP3 expression in unexplained recurrent spontaneous abortion patients. Fertil Steril. 2010;94(6):2244-7.
[22]Saifi B, Rezaee SA, Tajik N, Ahmadpour ME, Ashrafi M, Vakili R, et al. Th17 cells and related cytokines in unexplained recurrent spontaneous miscarriage at the implantation window. Reprod Biomed Online. 2014;29(4):481-9.
[23]Yue CY, Zhang B, Ying CM. Elevated serum level of IL-35 associated with the maintenance of maternal-fetal immune tolerance in normal pregnancy. Plos One. 2015;10(6):e0128219.