title: Prednisolone reduces preconceptual endometrial natural killer cells in women with recurrent miscarriage.
abstract: OBJECTIVE
  To test the hypothesis that high numbers of uterine natural killer (uNK) cells in the endometrium of women with recurrent miscarriage (RM) could be reduced with prednisolone.
  
  
  METHODS
  A before and after study.
  
  
  METHODS
  A tertiary referral teaching hospital.
  
  
  METHODS
  Eighty-five women with idiopathic RM recruited from all over the UK and 18 women attending for sterilization (controls).
  
  
  METHODS
  An endometrial sample was taken on day 21 +/- 2 of the menstrual cycle. Immunohistochemistry was used to identify uNK (CD56+, CD16-, CD3-). Twenty-nine women with RM and >5% uNK agreed to take 20 mg oral prednisolone daily from day 1 to 21 of their menstrual cycle, when a second biopsy was obtained and analyzed.
  
  
  METHODS
  The percentage of stromal cells that were uNK. The normal range was defined using control samples as <5%.
  
  
  RESULTS
  Women with RM had significantly more uNK than the controls (P=.008). Prednisolone treatment significantly reduced the number of CD56 cells in the endometrium, from a median of 14% (before) to 9% (after) (P=.0004).
  
  
  CONCLUSIONS
  We have demonstrated that high numbers of uNK in preimplantation endometrium of women with recurrent miscarriage can be reduced with administration of prednisolone.
authors.affiliation: School of Reproductive and Developmental Medicine, University of Liverpool, Liverpool, United Kingdom. squenby@liverpool.ac.uk
authors.forename: Siobhan
authors.initials: S
authors.lastname: Quenby
authors.forename: Chimwemwe
authors.initials: C
authors.lastname: Kalumbi
authors.forename: Michelle
authors.initials: M
authors.lastname: Bates
authors.forename: Roy
authors.initials: R
authors.lastname: Farquharson
authors.forename: Gill
authors.initials: G
authors.lastname: Vince
mesh_terms: D000026:Abortion, Habitual / Q000188:drug therapy* / Q000276:immunology / Q000473:pathology; D000328:Adult; D004717:Endometrium / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D005260:Female; D005306:Fertilization / Q000187:drug effects* / Q000276:immunology; D006801:Humans; D007694:Killer Cells, Natural / Q000187:drug effects* / Q000276:immunology / Q000473:pathology; D008875:Middle Aged; D011239:Prednisolone / Q000494:pharmacology* / Q000627:therapeutic use; D011247:Pregnancy; D018709:Statistics, Nonparametric
chemical_list: D011239:Prednisolone