ARTICLE INFO

Article Type

Systematic Review

Authors

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: 1396956111‎
Phone: ‎+98 (21) 44670888‎
Fax: ‎+98 (21) 44670432‎
ahadzr@gmail.com

Article History

Received:   March  5, 2017
Accepted:   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. ‎


CITATION LINKS

[1]Tripathi S, Guleria I. Role of PD1/PDL1 pathway, and TH17 and treg cells in maternal tolerance to the fetus. ‎Biomed J. 2015;38(1):25-31.‎
[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.‎