Immunological characteristics of nonpregnant women with unexplained recurrent spontaneous abortion who underwent paternal lymphocytes immunization.
The purpose of this study was to analyze the immunological characteristics of nonpregnant women with recurrent spontaneous abortions (RSA) of unknown etiology. We analyzed how differences of the immunological state of individual groups of women with RSA and various types of RSA (primary vs. secondary aborters) might influence on results of paternal lymphocytes immunization. In this prospective study the immunological characteristics of 117 nonpregnant women with unexplained RSA in comparison to 44 healthy, nonpregnant multigravid women, were analyzed. The following immunological parameters were studied: peripheral blood lymphocyte subpopulations (CD3+, CD4+, CD8+, CD3+/HLA-DR+), lymphocyte proliferative response to phytohaemaglutynin (PHA) and allogenic lymphocytes (in mixed lymphocyte reaction--MLR), the effect of women's sera on MLR, neutrophil chemiluminescence and anticardiolipin (ACA) as well as antinuclear (ANA) antibodies titers. We found that in nonpregnant RSA women the CD8+ lymphocytes percentage was lower (20.2% vs. 23.9%) and the CD4+/CD8+ ratio higher (2.37 vs. 1.9) as compared to the controls. In comparison with normal multigravidas in recurrent aborters an absence of serum factors suppressing MLR (blocking antibodies) and a high incidence of autoantibodies was observed (ACA: 53.8% vs. 9.1%; ANA: 42.7% vs. 6.8%). The pregnancy success ratio was significantly lower for alloimmunized women with medium/high titers of ACA than for those without ACA (64% vs. 96%, p < 0.001). It was proved there were no significant differences in the estimated immunological parameters between groups of women suffering from either primary or secondary abortions. It was also shown that there is an equally high efficiency of paternal lymphocyte immunization in preventing future abortions both in primary (88%) and secondary (86%) aborters. In conclusion it can be assumed that considering the immunological conditions of nonpregnant women with recurrent spontaneous abortion of unexplained etiology differ from healthy and fertile women. These differences are mainly connected to the humoral immunity and manifested in absence of blocking antibodies in sera of women with RSA and in frequent occurrence of antinuclear and anticardiolipin antibodies. Among autoantibodies, only ACA at medium and high levels are the ones that can negatively influence on the pregnancy outcome in women with RSA who underwent paternal lymphocytes immunization. The clinical classification of women with RSA into primary and the secondary aborters is reflected neither in immunological results nor in efficacy of paternal lymphocytes immunization.
Malinowski
A
A
Dept. of Obstetrics and Gynecology, Military Medical Academy, Polish Mother's Memorial Institute, Lódz/Poland.
Wilczynski
J
J
Zeman
K
K
Glowacka
E
E
Kolasa
D
D
Szpakowski
A
A
Oszukowski
P
P
Szpakowski
M
M
D000026:Abortion, Habitual / Q000276:immunology* / Q000517:prevention & control; D017153:Antibodies, Anticardiolipin / Q000097:blood; D019138:Antibodies, Blocking / Q000276:immunology; D001323:Autoantibodies / Q000276:immunology*; D016516:CD4-CD8 Ratio; D005220:Fathers; D005260:Female; D006801:Humans; D016219:Immunotherapy, Adoptive; D007231:Infant, Newborn; D008213:Lymphocyte Activation / Q000276:immunology; D016131:Lymphocyte Subsets / Q000276:immunology*; D008297:Male; D011247:Pregnancy; D016896:Treatment Outcome
D017153:Antibodies, Anticardiolipin; D019138:Antibodies, Blocking; D001323:Autoantibodies