Correlation between peritoneal fluid and serum antiphospholipid antibodies in women with primary infertility.

OBJECTIVE: To compare the peritoneal and serum levels of antiphospholipid antibodies (aPLs) against the following phospholipids: cardiolipin, L-alpha-phosphatidic acid, L-alpha-phosphatidylethanolamine, 1-alpha-phosphatidyl-DL-glycerol, L-alpha-phosphatidyl-inositol, L-alpha-phosphatidyl-L-serine in immunoglobulin isotypes of G, M, and secretory A. PATIENTS AND METHODS: A group of 107 women with primary infertility were immunologically examined. An ELISA method was used for detection of aPLs. RESULTS: aPL-L-serine and aPL-cardiolipin predominate over peritoneal fluid in all studied Ig isotypes (G, M, secretory A). Levels of aPL-ethanolamine are much higher in peritoneal sIgA and IgM than in sera. There is a predominance of IgG-aPLs-inositol, DL-glycerol, and aPL-acid in serum, and of sIgA in peritoneal fluid. CONCLUSION: Our patients had higher levels of aPLs (IgG, IgM, sIgA) against cardiolipin, serine, and ethanolamine in peritoneal fluid than in sera. The prevalence of aPLs in IgG was against DL-glycerol, phosphatidyl-inositol, and phosphatidic acid. It is quite difficult to estimate whether the aPLs have an influence directly through phospholipid epitopes on uterine mucous membrane, on the surface of oocytes, or on the surface of the early embryo during the fertilization and/or implantation process.

[Profile of antiphospholipid antibodies in various diagnoses associated with reproduction]. / Profil antifosfolipidových protilátek u ruzných diagnóz vázajících se k reprodukci.

The authors investigated antiphospholipid antibodies (APA) against phosphatidic acid, ph-ethanolamine, ph-DL-glycerol, ph-inositol, ph-L-serine and cardiolipine in isotypes IgG and IgM in various diagnoses associated with reproduction. They found that the most varied pattern of high levels of these antibodies is in particular in patients with the diagnosis of intractable infertility (in 26.5% women IgG against cardiolipine, in 24.5% patients IgG against ph-inositol and ph-DL-glycerol, in 17.6% women IgG against ph-ethanolamine, in 20.6% women IgG against phosphatidic acid antigens). Intractable infertility, repeated failures of IVF and patients with a basic autoaggressive disease were followed up and their antiphospholipid antibodies were assessed. In one patient follow up of APA revealed SLE before the patient developed clinical symptoms of the disease.

[Zona pellucida antibodies determined by the passive hemagglutination reaction--I. Methods]. / Protilátky proti zona pellucida vysetrované pasivní hemaglutinacní reakcí--I. Metodická cást.

Antibodies against the zona pellucida can block the fertilization process. The authors elaborated therefore a feasible examination method for the needs of the Clinic of Immunology of Reproduction of the Gynaecological and Obstetric Department in Plzen. Using three different extraction solubilization methods and chromatographic partition, they obtained a total of 11 porcine antigenic zonal fractions (from 13.2-114 kDa) which formed the basis for a passive haemagglutination reaction. As a control component they used antiserum of immunized female rabbits. A large number of experiments became the basis for examination of sera of patients with reproductive disorders.

[Monitoring immunity factors in serum and peritoneal fluid after laparoscopy in women. II. Sperm and zona pellucida antibodies]. / Sledování nekterých faktoru imunity v séru a v peritoneální tekutine u laparoskopovaných zen--II. Protilátky proti spermiím a proti zona pellucida.

A team of authors investigated antibody levels against spermatozoa and against the zona pellucida in sera and peritoneal fluids in infertile women where diagnostic laparoscopy was indicated. The immunological cause of infertility was diagnosed in some women with a normal laparoscopic finding on the inner genital, as well as in patients with endometriosis and in women with adhesions. A minimal antibody response to antigens of gametes was recorded in women with the diagnosis of uterus myomatosus, uterus hypoplasticus and polycystic ovary. The authors present detailed findings on antibodies in different groups of patients.

[Immunologic factors in the serum and peritoneal fluid in women after laparoscopy. I. Nonspecific factors]. / Sledování nekterých faktoru imunity v séru a v peritoneální tekutine u laparoskopovaných zen. I. Nespecifické faktory.

The authors examined by diagnostic laparoscopy and immunologically 180 patients in 1993-1995. They assessed in serum and peritoneal fluid IgG, IgA, IgM, haptoglobulin, A2-macroglobulin, A1-antitrypsin, transferrin, C4- and C3-complement, orosomucoid, A2AP-glycoprotein, albumin, prealbumin and hemopexin. The authors found that some individual pathological results as regards non-specific immunity supplement the clinical diagnosis, in particular in endomeriosis, multiple adhesions, polycystic ovaries and chronic anovulation.

[Immunologic factors in human colostrum and milk]. / Nekteré imunologické faktory lidského kolostra a mléka.

BACKGROUND: The mammary gland is at present conceived as an immunological secretory organ, capable of producing specific and non-specific factors transmitted into colostrum or milk. METHODS AND RESULTS: Colostrum was collected from the 1st to 3rd day after delivery, milk on the 4th to 19th day after delivery. Colostrum from 42 and milk from 63 mothers was examined. Levels of the following were assessed: IgG, IgM, IgD, IgA, sIgA, SCIgA, C3, C4, orosomucoid, prealbumin, alpha 1-antitrypsin, alpha 1-fetoprotein, alpha 2-macroglobulin, haemopexin, haptoglobin, beta 2-microglobulin, alpha 2-AP glycoprotein (methodradial immunodiffusion) and IgE (ELISA). Colostrum contains more IgG, SCIgA, almost three times more IgM, IgA and secretory IgA than milk. IgD was not detected. Factors of non-specific immunity were found only in low concentrations. CONCLUSIONS: Human colostrum and milk are from the immunological aspect an important liquid with proven bacteriostatic and inhibitory activity preventing penetration of pathogenic microorganisms and absorption of potential allergens into the digestive and respiratory tract of the neonate. From the immunological aspect it is essential to promote breastfeeding.

[The role of anti-ulcerative drugs in treatment and prevention of gastropathies induced by nonsteroidal anti-inflammatory drugs]. / Uloha antiulcerózních léciv v lécbe a prevenci gastropatií vyvolaných nesteroidními antirevmatiky.

Nonsteroidal anti-inflammatory drugs (NSAIDs) as effective agents for the relief of pain and inflammation are among the most widely prescribed drugs. Unfortunately, their benefits especially for patients with osteoarthritis and other chronic musculoskeletal conditions, are accompanied by well established toxicity. A significant percentage of NSAIDs users experience some type of gastrointestinal adverse events, ranging from manageable dyspepsia to clinically important complications (gastrointestinal bleeding, ulcer perforation, obstruction). In an attempt to reduce the incidence of NSAID-induced gastropathy, the following approaches have been proposed: avoidance of NSAIDs or minimising their dosage, selecting NSAID known to cause less damage and coprescription of various agents. Patients who require NSAIDs therapy should be assessed for factors that increase risk of gastrointestinal damage. In high risk patients, use of misoprostol, which reduces even serious gastrointestinal complications, or proton pump inhibitors, whose efficacy in preventing gastroduodenal ulcers due to NSAIDs exposure has been demonstrated in large clinical trials, is possible to use. The first step in the treatment of NSAID-associated ulcers lies in discontinuation of NSAIDs therapy. If NSAIDs cannot be withdrawn, an antisecretory therapy should be initiated. Proton pump inhibitors appear to be the most effective at healing NSAID-related ulcers among whose with continuous NSAIDs therapy. Another therapeutic option in the management of NSAID-gastropathy is to use specific cyclooxygenase-2 inhibitors. However, the clinical experience with these agents is still limited and further surveillance to resolve this issue as well as e.g. the role of Helicobacter pylori infection in NSAID-induced gastrointestinal injury are needed.

Antispermatozoal antibodies in human colostrum and milk.

Authors studied antisperm activity in human colostrum and milk by tray agglutination (TAT) and indirect mixed antiglobulin reaction (MAR) tests. Spermagglutination observed by TAT was found in 10 patients (24%) in colostrum, in 3 (5%) in milk. Character of spermantibodies by indirect MAR-test showed the presence of sIgA in 6 (14%), in IgG in 4 (9.5%) in colostrum, the presence of sIgA in 3 (4.8%), of sIgA and IgG together in 1 (1.7%) in milk. Authors discuss the origin of these antibodies.