Alloimmune and autoimmune background in recurrent pregnancy loss - successful immunotherapy by intravenous immunoglobulin.
OBJECTIVE
Immunotherapies [leukocyte immunization, intravenous immunoglobulin (IVIG)] introduced to treat women with recurrent spontaneous abortions (RSA) have still controversial results in most clinical trials. A selection of these patients would be advantageous for higher efficacy.


METHODS
A complex immunological panel assay was offered to patients with reproductive failure without any other known cause. We focused here on the cellular immunological parameters.


RESULTS
High cytotoxic T lymphocyte precursor frequency and cell-mediated cytotoxic activity and a rather high natural killer cell activity were found in alloimmune RSA patients. Thirty-two patients were investigated by immunological assays and in 78% of the women an alloimmune background could be defined. The efficacy of IVIG treatment was 96% in this group.


CONCLUSIONS
The novel cellular immunological assays proved to be favourable for the indication of RSA patients and showed the usefulness of this selection process for effective immunotherapy.
Kotlan
Beatrix
B
National Medical Center, Institute of Haematology and Immunology, Budapest, Hungary. kotlanb@netscape.net
Padanyi
Agnes
A
Batorfi
Jozsef
J
Fulop
Vilmos
V
Szigetvari
Ivan
I
Rajczy
Katalin
K
Penzes
Maria
M
Gyodi
Eva
E
Reti
Marienne
M
Petranyi
Gyozo
G
D000026:Abortion, Habitual / Q000276:immunology* / Q000628:therapy*; D000328:Adult; D001323:Autoantibodies; D015551:Autoimmunity; D016022:Case-Control Studies; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007518:Isoantibodies; D007694:Killer Cells, Natural / Q000276:immunology; D011247:Pregnancy; D013602:T-Lymphocytes, Cytotoxic / Q000276:immunology
D001323:Autoantibodies; D016756:Immunoglobulins, Intravenous; D007518:Isoantibodies