Etanercept immunotherapy in women with a history of recurrent reproductive failure.
OBJECTIVE
The aim of the study was to evaluate the effect of etanercept immunotherapy on peripheral natural killer (NK) cell activity in women with a history of recurrent miscarriage (RM) or failed in vitro fertilization (IVF).


METHODS
Thirty nonpregnant women with reproductive failure and increased peripheral NK-cell number and/or activity before conception were studied. Women with reproductive failure received 4 doses (25 mg) of etanercept twice weekly before conception. Peripheral NK-cell activity before and after etanercept therapy in RM women was measured using flow cytometry In addition, the peripheral blood NK-cell surface antigens- CD16- and CD56 and peripheral blood regulatory T cell (T reg) antigens- CD4- and CD25 were studied using flow cytometry before treatment and 2 weeks after the last etanercept dose.


RESULTS
NK-cell activity was significantly decreased after etanercept therapy in the study women (P < .05). This effect was significantly higher in women with subsequent pregnancy success (P < .05), but not in those with pregnancy failure (P > .05). There were no significant differences in T reg level before and after etanercept therapy (P > 0.05).


CONCLUSIONS
Etanercept therapy might be effective treatment for women with increased NK-cell activity. Regulation of immune system activity may underlie the possible effect of such therapy.
Department of Gynecology and Gynecological Oncology, Military Institute of Medicine, Warsaw, Poland. mmjerzak@wp.pl
Małgorzata
M
Jerzak
Monika
M
Ohams
Andrzej
A
Górski
Włodzimierz
W
Baranowski
D000026:Abortion, Habitual / Q000517:prevention & control; D000328:Adult; D015703:Antigens, CD / Q000032:analysis; D019002:CD56 Antigen / Q000032:analysis; D000068800:Etanercept; D005260:Female; D005300:Fertility Agents, Female / Q000008:administration & dosage*; D005307:Fertilization in Vitro; D006801:Humans; D007074:Immunoglobulin G / Q000008:administration & dosage*; D007166:Immunosuppressive Agents / Q000008:administration & dosage*; D007167:Immunotherapy / Q000379:methods*; D007247:Infertility, Female / Q000188:drug therapy* / Q000276:immunology; D007694:Killer Cells, Natural / Q000187:drug effects*; D011247:Pregnancy; D018124:Receptors, Tumor Necrosis Factor / Q000008:administration & dosage*; D016896:Treatment Outcome
D015703:Antigens, CD; D019002:CD56 Antigen; D005300:Fertility Agents, Female; D007074:Immunoglobulin G; D007166:Immunosuppressive Agents; D018124:Receptors, Tumor Necrosis Factor; D000068800:Etanercept