Immunogenetic and serological investigations in nonpregnant and in pregnant women with a history of recurrent spontaneous abortions. German RSA/IVIG Study Group.
In the context of a controlled multicenter study on intravenous immunoglobulin (IVIG) treatment of patients with a history of unexplained recurrent spontaneous abortions (RSA), a number of controversial immunological parameters were evaluated prior to and during pregnancy with respect to their diagnostic and/or prognostic significance. A total of 390 serum samples from 52 patients were investigated. Sharing of 2 or more HLA (A, B, DR, DQ) antigens was significantly more frequent in RSA couples than in controls. The rate of cytotoxic or Fc-receptor (FcR)-blocking antibodies was not significantly lower in RSA patients than in individuals with normal pregnancies. Both tumor necrosis factor-alpha (TNF-alpha) levels and IgG anticardiolipin antibodies (IgG-ACA) were significantly increased in the patient group. While the occurrence of HLA sharing, cytotoxic/FcR-blocking antibodies and IgG-ACA did not correlate with the outcome of pregnancy, TNF-alpha levels were found to be significantly higher in patients with subsequent miscarriage than in those with successful pregnancy. IgG-ACA, if present, significantly decreased during the course of successful pregnancy but remained high in patients with subsequent abortion. It is concluded that the diagnostic and/or prognostic value of HLA sharing and cytotoxic/FcR-blocking antibodies has been overestimated while TNF-alpha and ACA levels are potential diagnostic markers and/or exhibit prognostic significance in subgroups of RSA patients.
Mueller-Eckhardt
G
G
Institute for Clinical Immunology, and Transfusion Medicine, Justus Liebig University, Giessen, Germany.
Mallmann
P
P
Neppert
J
J
Lattermann
A
A
Melk
A
A
Heine
O
O
Pfeiffer
R
R
Zingsem
J
J
Domke
N
N
Mohr-Pennert
A
A
D000026:Abortion, Habitual / Q000235:genetics* / Q000276:immunology* / Q000628:therapy; D000906:Antibodies / Q000097:blood; D017153:Antibodies, Anticardiolipin / Q000097:blood; D001667:Binding, Competitive; D015415:Biomarkers; D003602:Cytotoxicity, Immunologic; D005220:Fathers; D005260:Female; D006680:HLA Antigens / Q000235:genetics; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use; D008297:Male; D011247:Pregnancy; D011256:Pregnancy Outcome; D011961:Receptors, Fc / Q000276:immunology; D014409:Tumor Necrosis Factor-alpha / Q000378:metabolism
D000906:Antibodies; D017153:Antibodies, Anticardiolipin; D015415:Biomarkers; D006680:HLA Antigens; D016756:Immunoglobulins, Intravenous; D011961:Receptors, Fc; D014409:Tumor Necrosis Factor-alpha