title: Determination of clinical cellular immune markers in women with recurrent pregnancy loss.
abstract: OBJECTIVE
  Dysregulated natural killer (NK) immunity and T-cell immunity are associated with recurrent pregnancy loss (RPL). We aim to define clinically relevant NK and T-cell parameters for RPL and determine their cutoff values.
  
  
  METHODS
  Ninety-five women with RPL (>3) including 42 idiopathic and 53 known-etiology RPL, and 29 age-matched fertile controls were enrolled. Peripheral blood immunophenotype, NK cell cytotoxicity (NKC), and T-helper (Th) 1 and Th2 cytokine producing cell ratios (Th1/Th2) were measured using flowcytometry. The cutoff values were determined using Youden's J with likelihood ratio (LR) >2.
  
  
  RESULTS
  Natural killer cell percentage and NKC, TNF-α(+) Th1 cells, and TNF-α/IL-10 producing Th1/Th2 cell ratio were significantly higher in idiopathic RPL than controls. By the area under the curve (AUC) analysis, NK cell percentage (AUC = 0.691), NKC (AUC = 0.649), TNF-α(+) Th1 cells (AUC = 0.681) and Th1/Th2 cell ratio (AUC = 0.660) were highly specific for RPL. The cutoff values for NK cell percentage, NKC (E:T cell ratio 25:1), and TNF-α/IL-10 producing Th1/Th2 cell ratio are 16.1, 23.8, and 36.2%, respectively. Seventy-six percent of idiopathic RPL showed at least one of more immune abnormalities by these criteria.
  
  
  CONCLUSIONS
  Differences in NK cell percentages, NKC and Th1/Th2 cell ratio differentiated RPL from fertile controls.
authors: Department of Obstetrics and Gynecology, College of Medicine, Konyang University, Daejeon, Korea.
authors: Sung Ki
authors: SK
authors: Lee
authors: Baeg Ju
authors: BJ
authors: Na
authors: Jee Yun
authors: JY
authors: Kim
authors: Sung Eun
authors: SE
authors: Hur
authors: Millina
authors: M
authors: Lee
authors: Alice
authors: A
authors: Gilman-Sachs
authors: Joanne
authors: J
authors: Kwak-Kim
mesh_terms: D000026:Abortion, Habitual / Q000175:diagnosis* / Q000276:immunology; D000328:Adult; D015415:Biomarkers / Q000378:metabolism; D002478:Cells, Cultured; D016207:Cytokines / Q000378:metabolism; D003602:Cytotoxicity, Immunologic; D005260:Female; D006801:Humans; D007111:Immunity, Cellular; D016130:Immunophenotyping; D007694:Killer Cells, Natural / Q000276:immunology*; D016013:Likelihood Functions; D011247:Pregnancy; D012015:Reference Standards; D000090822:Ribosomal Protein L3; D013601:T-Lymphocytes / Q000276:immunology*; D058408:Th1-Th2 Balance; D055815:Young Adult
chemical_list: D015415:Biomarkers; D016207:Cytokines; C000716547:RPL3 protein, human; D000090822:Ribosomal Protein L3
keywords: Cutoff value; TNF-α; cytokines; natural killer cell cytotoxicity; natural killer cells; recurrent pregnancy loss