ABSTRACT
PROBLEM: Natural killer (NK, CD3(-)CD56(+)/CD16(+)) and NKT-like cells (CD3(+)CD56(+)/CD16(+)) activity is considered among the key factors for reproductive success. In the absence of immunological screening, beneficial effects of intravenous immunoglobulin (IVIG) in preventing recurrent reproductive failure (RRF) have not been reported. Here, we analyse the IVIG influence on pregnancy success in women with RRF and circulating NK or/and NKT-like cells expansion. METHOD OF STUDY: One hundred fifty-seven women with previous recurrent miscarriage and/or recurrent implantation failure after in vitro fertilization were consecutively studied. Sixty-four patients with CD56(+) cell expansion, no apparent underlying disease and who maintained their desire to conceive were selected. Forty of them received IVIG during pregnancy. RESULTS: Overall, the clinical pregnancy rate for the women under IVIG therapy was 92.5% and the live birth rate was 82.5%. Significantly lower pregnancy and live birth rates (25% and 12.5%, respectively) were observed for the patients with recurrent pregnancy loss and NK/NKT-like cells expansion without IVIG. After three cycles of IVIG, NK cell percentages decreased significantly and these values persisted throughout gestation. CONCLUSION: Intravenous immunoglobulin therapy for women with RRF and NK or NKT-like cell expansion was a safe and beneficial therapeutic strategy that associated with high clinical pregnancy and live birth rates.
Subject(s)
Abortion, Habitual/prevention & control , Immunoglobulins, Intravenous/administration & dosage , Immunologic Factors/administration & dosage , Killer Cells, Natural/immunology , Live Birth , Natural Killer T-Cells/immunology , Abortion, Habitual/blood , Abortion, Habitual/immunology , Adult , Female , Humans , Killer Cells, Natural/metabolism , Lymphocyte Count , Natural Killer T-Cells/metabolism , Pregnancy , Retrospective Studies , SpainABSTRACT
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Subject(s)
Humans , Male , Middle Aged , Tetanus Toxoid/adverse effects , Alopecia Areata/chemically induced , HLA-B Antigens/analysisABSTRACT
Although undesirable, immune reconstitution syndrome (IRS) indicates a favourable effect of HAART and it should be differentiated from an opportunistic infection because of their distinct implications and management. Our group analysed different immunological parameters with the aim of identifying IRS predictors in patients who begin HAART. We found that CD8(+)CD25(+) cell pretreatment values in patients who developed IRS were four times higher than in those patients who did not develop IRS.