Unexplained recurrent early miscarriages: Role of immunomodulation?

被引:6
作者
Mekinian, A. [1 ]
Cohen, J. [2 ]
Kayem, G.
Carbillon, L. [3 ]
Nicaise-Roland, P. [4 ]
Gaugler, B. [5 ]
Darai, E. [2 ]
Bornes, M. [2 ]
Fain, O. [1 ]
机构
[1] Univ Paris 06, Hop St Antoine, AP HP, Serv Med Interne & Inflammat DHU i2B, 184 Rue Faubourg St Antoine, F-75012 Paris, France
[2] Univ Paris 06, Hop Tenon, AP HP, UMRS 938,Serv Obstet & Procreat Medicalement Assi, F-75020 Paris, France
[3] Univ Paris 06, Hop Trousseau, AP HP, Serv Obstet, F-75012 Paris, France
[4] Univ Paris 07, Hop Bichat, AP HP, Serv Autoimmun & Hypersensibil, F-75018 Paris, France
[5] INSERM, Ctr Rech St Antoine, UMR S 938, F-75012 Paris, France
来源
REVUE DE MEDECINE INTERNE | 2017年 / 38卷 / 04期
关键词
Unexplained recurrent early miscarriages; Immunomodulation; Biological-targeted agents; IN-VITRO FERTILIZATION; REGULATORY T-CELLS; INTRAVENOUS IMMUNOGLOBULIN TREATMENT; COLONY-STIMULATING FACTOR; IMPLANTATION FAILURE; SPONTANEOUS-ABORTION; PERIPHERAL-BLOOD; DOUBLE-BLIND; NK CELLS; REPRODUCTIVE FAILURE;
D O I
10.1016/j.revmed.2016.08.001
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
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. (C) 2016 Societe Nationale Francaise de Medecine Interne (SNFMI). Published by Elsevier Masson SAS. All rights reserved.
引用
收藏
页码:264 / 268
页数:5
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