Immunological Risk Factors in Recurrent Pregnancy Loss in Patients With Hereditary Thrombophilia

被引:2
作者
Kirovakov, Zlatko [1 ,2 ]
Konova, Emiliana [3 ]
Hinkova, Nadezhda [1 ]
Markova, Stefani [2 ]
Penchev, Plamen [4 ]
机构
[1] Med Univ Pleven, Fac Hlth Care, Dept Midwifery Care, Pleven, Bulgaria
[2] Univ Hosp Act Treatment Burgas, Dept Obstet & Gynecol, Burgas, Bulgaria
[3] Med Univ Pleven, Clin Inst Reprod Med, Pleven, Bulgaria
[4] Med Univ Plovdiv, Fac Med, Plovdiv, Bulgaria
关键词
pregnancy outcomes; cytokine levels; antiphospholipid antibodies; immunological factors; hereditary thrombophilia; recurrent pregnancy loss; ANTIPHOSPHOLIPID ANTIBODIES; T-CELLS; MISCARRIAGE; WOMEN; T-HELPER-1; RESPONSES;
D O I
10.7759/cureus.56555
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: Recurrent pregnancy loss (RPL) is a complicated reproductive disorder with underlying genetic and immunological causes. RPL may be influenced by hereditary thrombophilia, a class of blood clottingrelated genetic abnormalities, via the vascular and immune systems. This study examines the immunological characteristics that hereditary thrombophilia patients have in common with RPL. Methods: A prospective cohort study included 300 patients split into two groups: a control group without hereditary thrombophilia and a group with the condition. Interleukin-6 (IL -6), tumor necrosis factor -alpha (TNF-alpha), and interferon -gamma (IFN-gamma) levels were measured, along with demographic specifics, antiphospholipid antibodies, natural killer (NK) cell counts, and other cytokines. Group differences were found using statistical analysis. Results: Antiphospholipid antibodies were significantly more common in the thrombophilia group (42% testing positive, p=0.001) compared to the control group (12% testing positive), despite demographic factors being similar between groups (p=0.372 and p=0.093). When body mass index (BMI) was taken into account, the study found a statistically significant difference (p=0.046), with the thrombophilia group having a higher mean BMI (26.3 kg/m2, standard deviation (SD): 2.8) than the control group (24.7 kg/m 2, SD: 3.1). IL -6 (14.8 pg/mL, SD: 3.2, p=0.029) were higher than the control group (12.4 pg/mL, SD: 2.1), and TNF-alpha levels were higher in the thrombophilia group (10.5 pg/mL, SD: 2.0, p=0.012) compared to the control group (8.9 pg/mL, SD: 1.5), but NK cell counts did not differ significantly (p=0.213). Conclusion: This study emphasizes the role of elevated pro -inflammatory cytokines (IL -6 and TNF-alpha) and antiphospholipid antibodies in RPL among people with hereditary thrombophilia. In this population, early detection and immunomodulatory interventions may improve pregnancy outcomes. To fully comprehend these mechanisms and create customized treatments, collaborative research is required.
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页数:7
相关论文
共 28 条
[1]   Endothelial nitric oxide synthase gene polymorphism in a cohort of Egyptian women with recurrent spontaneous miscarriage [J].
Abulata N.N. ;
AbdalWahab D.F. ;
Osman O.M. .
Comparative Clinical Pathology, 2015, 24 (3) :629-634
[2]   How strong is the association between maternal thrombophilia and adverse pregnancy outcome? A systematic review [J].
Alfirevic, Z ;
Roberts, D ;
Martlew, V .
EUROPEAN JOURNAL OF OBSTETRICS & GYNECOLOGY AND REPRODUCTIVE BIOLOGY, 2002, 101 (01) :6-14
[3]   Immunological memory and tolerance at the maternal-fetal interface: Implications for reproductive management of mares [J].
Antczak, Douglas F. .
THERIOGENOLOGY, 2020, 150 :432-436
[4]   Recurrent Miscarriage [J].
Branch, D. Ware ;
Gibson, Mark ;
Silver, Robert M. .
NEW ENGLAND JOURNAL OF MEDICINE, 2010, 363 (18) :1740-1747
[5]   Management of the obstetric antiphospholipid syndrome [J].
Derksen, RHWM ;
Khamashta, MA ;
Branch, DW .
ARTHRITIS AND RHEUMATISM, 2004, 50 (04) :1028-1039
[6]  
Di Simone N, 2000, ARTHRITIS RHEUM-US, V43, P140, DOI 10.1002/1529-0131(200001)43:1<140::AID-ANR18>3.0.CO
[7]  
2-P
[8]   Antiphospholipid Antibodies Affect Human Endometrial Angiogenesis [J].
Di Simone, Nicoletta ;
Di Nicuolo, Fiorella ;
D'Ippolito, Silvia ;
Castellani, Roberta ;
Tersigni, Chiara ;
Caruso, Alessandro ;
Meroni, Pierluigi ;
Marana, Riccardo .
BIOLOGY OF REPRODUCTION, 2010, 83 (02) :212-219
[9]   Immunogenetic contributions to recurrent pregnancy loss [J].
Grimstad, Frances ;
Krieg, Sacha .
JOURNAL OF ASSISTED REPRODUCTION AND GENETICS, 2016, 33 (07) :833-847
[10]   Decidual NK cells regulate key developmental processes at the human fetal-maternal interface [J].
Hanna, Jacob ;
Goldman-Wohl, Debra ;
Hamani, Yaron ;
Avraham, Inbal ;
Greenfield, Caryn ;
Natanson-Yaron, Shira ;
Prus, Diana ;
Cohen-Daniel, Leonor ;
Arnon, Tal I. ;
Manaster, Irit ;
Gazit, Roi ;
Yutkin, Vladimir ;
Benharroch, Daniel ;
Porgador, Angel ;
Keshet, Eli ;
Yagel, Simcha ;
Mandelboim, Ofer .
NATURE MEDICINE, 2006, 12 (09) :1065-1074