The occurrence of immunological disturbances in patients with recurrent miscarriage (RM) of unknown etiology.
OBJECTIVE
The 155 patients suffering from primary RM who took part in this study were qualified after excluding known causes of abortions.


METHODS
The presence of the following immunological factors was examined in serum samples: autoantibodies such as anti-cardiolipin (ACA) IgG and IgM, lupus-anticoagulant (LA), anti-thyroid (ATA): anti-thyroglobulin (anti-TG) and anti-thyroid peroxydase (anti-TPO), anti-nuclear (ANA), anti-placental (APA) antibodies and alloimmunological disturbances following HLA-class I antibody test (LCT-lymphocytotoxic test), lack of blocking proliferative activity in mixed lymphocyte reaction test (MLR), anti-sperm (ASA) antibodies, levels of extracellular interferon γ (IFN γ) and tumour necrosis α (TNFα) produced by peripheral blood lymphocytes.


RESULTS
Immunological disturbances were found in 69.1% of the patients suffering from primary RM of unknown etiology. The number of RM correlated with the frequency of immunological disturbance. Among the samples from patients who underwent ≥5 RM, positive levels of TNFα were the most frequently observed risk factor (up to 27%) (p=0.05). Although the incidence of immunological factors was comparable between patients with early and late pregnancy losses, elevated ATA levels were frequently seen among late miscarriage (95% CI=36.0, p≤0.01).


CONCLUSIONS
The heterogeneity of immunological risk factors shown in this study indicates the usefulness of detecting alloimmune factors as well as autoantibodies in patients with RM of unknown etiology. This may be helpful to analyse the therapeutical effectivity of various treatment in a better characterized group of patients and to explain unsuccessful results of treatment in patients with RM of unknown etiology.
The Opole University of Technology, Faculty of Physical Education and Physiotherapy, Opole, Poland. hannamotak@o2.pl.
Hanna
H
Motak-Pochrzest
Department of Operative and Endoscopic Gynaecology, Polish Mother's Memorial Hospital Research Institute, Lodz, Poland.
Andrzej
A
Malinowski
D000026:Abortion, Habitual / Q000453:epidemiology* / Q000209:etiology / Q000276:immunology*; D000328:Adult; D017153:Antibodies, Anticardiolipin / Q000097:blood; D000974:Antibodies, Antinuclear / Q000097:blood; D001323:Autoantibodies / Q000097:blood*; D005260:Female; D006801:Humans; D007371:Interferon-gamma / Q000097:blood; D016682:Lupus Coagulation Inhibitor / Q000097:blood; D008875:Middle Aged; D010920:Placenta / Q000276:immunology; D011247:Pregnancy; D012307:Risk Factors; D014409:Tumor Necrosis Factor-alpha / Q000097:blood; D055815:Young Adult
D017153:Antibodies, Anticardiolipin; D000974:Antibodies, Antinuclear; D001323:Autoantibodies; D016682:Lupus Coagulation Inhibitor; D014409:Tumor Necrosis Factor-alpha; C006606:anti-thyroglobulin; D007371:Interferon-gamma