title: [Unexplained recurrent early miscarriages: Role of immunomodulation?]
abstract: About 1-3% of women experience early recurrent miscarriages, defined by ≥3 fetal loss before 14 weeks of gestation. About half of these recurrent early miscarriages could be related to a genetic cause. Pre-implantation genetic diagnosis is used in several European countries, but it is still prohibited in France except for couples at risk for transmission of severe genetic diseases. The immune dysregulation, and in particular allo-immune excessive response, could be responsible for fetal loss in remaining cases, although currently we lack biomarker to confirm the immune-mediated fetal loss. Several immunosuppressive and immunomodulatory treatments have been the subject of small studies in patients with early recurrent miscarriages. The available data do not allow to define the treatment recommendations in this topic, and further studies are necessary.
authors.affiliation: Service de médecine interne et l'inflammation-(DHU i2B), hôpital Saint-Antoine, université Paris 06, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France. Electronic address: arsene.mekinian@sat.aphp.fr.
authors.forename: A
authors.initials: A
authors.lastname: Mekinian
authors.affiliation: UMRS-938, service d'obstétrique et de procréation médicalement assistée, hôpital Tenon, université Paris 06, AP-HP, 75020 Paris, France.
authors.forename: J
authors.initials: J
authors.lastname: Cohen
authors.affiliation: Service d'obstétrique, hôpital Trousseau, université Paris 06, AP-HP, 75012 Paris, France.
authors.forename: G
authors.initials: G
authors.lastname: Kayem
authors.affiliation: Service d'obstétrique, hôpital Jean-Verdier, université Paris 13, AP-HP, 93000 Bondy, France.
authors.forename: L
authors.initials: L
authors.lastname: Carbillon
authors.affiliation: Service d'auto-immunité et hypersensibilité, hôpital Bichat, université Paris 7, AP-HP, 75018 Paris, France.
authors.forename: P
authors.initials: P
authors.lastname: Nicaise-Roland
authors.affiliation: Centre de recherche Saint-Antoine, Inserm UMR_S 938, 75012 Paris, France.
authors.forename: B
authors.initials: B
authors.lastname: Gaugler
authors.affiliation: UMRS-938, service d'obstétrique et de procréation médicalement assistée, hôpital Tenon, université Paris 06, AP-HP, 75020 Paris, France.
authors.forename: E
authors.initials: E
authors.lastname: Darai
authors.affiliation: UMRS-938, service d'obstétrique et de procréation médicalement assistée, hôpital Tenon, université Paris 06, AP-HP, 75020 Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Bornes
authors.affiliation: Service de médecine interne et l'inflammation-(DHU i2B), hôpital Saint-Antoine, université Paris 06, AP-HP, 184, rue du Faubourg-Saint-Antoine, 75012 Paris, France.
authors.forename: O
authors.initials: O
authors.lastname: Fain
mesh_terms: D000026:Abortion, Habitual / Q000209:etiology / Q000276:immunology / Q000628:therapy*; D001688:Biological Products / Q000627:therapeutic use; D005260:Female; D005602:France; D005865:Gestational Age; D006801:Humans; D056747:Immunomodulation / Q000502:physiology*; D007166:Immunosuppressive Agents / Q000627:therapeutic use; D058990:Molecular Targeted Therapy / Q000379:methods / Q000639:trends; D011247:Pregnancy
chemical_list: D001688:Biological Products; D007166:Immunosuppressive Agents
keywords: Biological-targeted agents; Biothérapies; Fausses couches inexpliquées; Immunomodulation; Unexplained recurrent early miscarriages