Unexplained Recurrent Pregnancy Loss: Clinical Application of Immunophenotyping

IF 2.5 3区医学 Q3 IMMUNOLOGY American Journal of Reproductive Immunology Pub Date : 2024-10-11 DOI:10.1111/aji.13939

Irene Monticciolo, Alice Guarano, Annalisa Inversetti, Greta Barbaro, Nicoletta Di Simone

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Abstract

Problem

Recurrent pregnancy loss (RPL) is defined as the failure of two or more pregnancies and affects approximately 5% of couples, often without a clear cause. The etiologies of RPL include factors such as maternal age, endocrine dysfunction, uterine abnormalities, chromosomal abnormalities, thrombophilias, infections, and autoimmune disorders. However, these conditions account for only 50%–60% of RPL cases. Research has explored whether an altered immune system, compared to the physiological state, may be linked to RPL. This review aims to determine whether specific immunophenotypes are associated with unexplained Recurrent Pregnancy Loss (uRPL) and whether targeted therapies addressing specific immunophenotypic alterations can improve pregnancy outcomes.

Methods

A literature review was conducted using Pubmed/Medline, Scopus, and Embase databases, analyzing data from 95 articles published between 2001 and 2023. The roles of various cells of the immune system (B lymphocytes, T lymphocytes, natural killer cells, macrophages) in different tissues (peripheral blood, menstrual blood) were specifically investigated in women with uRPL.

Discussion and Conclusion

Specific immunophenotypes have been demonstrated to be associated with this condition. However, there is a need to standardize immunophenotyping assays and conduct more trials to stratify RPL risk and improve potential therapeutic strategies.

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不明原因的复发性妊娠失败：免疫分型的临床应用。

问题复发性妊娠失败（RPL）是指两次或两次以上的妊娠失败，约有 5%的夫妇会受到影响，通常没有明确的原因。RPL 的病因包括产妇年龄、内分泌功能失调、子宫异常、染色体异常、血栓性血友病、感染和自身免疫性疾病等因素。然而，这些情况只占 RPL 病例的 50%-60%。研究探讨了与生理状态相比，免疫系统的改变是否可能与 RPL 有关。本综述旨在确定特定的免疫表型是否与不明原因的复发性妊娠失败（uRPL）有关，以及针对特定免疫表型改变的靶向疗法是否能改善妊娠结局：我们使用 Pubmed/Medline、Scopus 和 Embase 数据库进行了文献综述，分析了 2001 年至 2023 年间发表的 95 篇文章的数据。方法：利用Pubmed/Mline、Scopus和Embed数据库进行了文献综述，分析了2001年至2023年期间发表的95篇文章的数据，特别研究了患有尿路感染的女性在不同组织（外周血、经血）中免疫系统各种细胞（B淋巴细胞、T淋巴细胞、自然杀伤细胞、巨噬细胞）的作用：讨论与结论：特定的免疫表型已被证实与该疾病相关。然而，有必要对免疫分型检测进行标准化，并开展更多试验来对 RPL 风险进行分层，并改进潜在的治疗策略。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American Journal of Reproductive Immunology 医学-免疫学

CiteScore

6.20

自引率

5.60%

发文量

314

审稿时长

2 months

期刊介绍： The American Journal of Reproductive Immunology is an international journal devoted to the presentation of current information in all areas relating to Reproductive Immunology. The journal is directed toward both the basic scientist and the clinician, covering the whole process of reproduction as affected by immunological processes. The journal covers a variety of subspecialty topics, including fertility immunology, pregnancy immunology, immunogenetics, mucosal immunology, immunocontraception, endometriosis, abortion, tumor immunology of the reproductive tract, autoantibodies, infectious disease of the reproductive tract, and technical news.