T-HELPER 1-TYPE IMMUNITY TO TROPHOBLAST IN WOMEN WITH RECURRENT SPONTANEOUS-ABORTION

被引:459
作者
HILL, JA
POLGAR, K
ANDERSON, DJ
机构
[1] HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DIV REPROD IMMUNOL,HARVARD RECURRENT MISCARRIAGE CTR,BOSTON,MA 02115
[2] HARVARD UNIV,BRIGHAM & WOMENS HOSP,SCH MED,DEPT OBSTET GYNECOL & REPROD BIOL,REPROD MED UNIT,BOSTON,MA 02115
来源
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION | 1995年 / 273卷 / 24期
关键词
D O I
10.1001/jama.273.24.1933
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Objective.-To test the hypothesis that peripheral blood mononuclear cells in women with unexplained recurrent abortion (URA) produce T-helper 1 (T(H)1)-type cytokines in response to trophoblast antigens. Design.-Cohort study. Setting.-Medical center, Participants.-A total of 244 women with URA, 13 reproductively normal parous control women, and 10 men. Main Outcome Measures.-Supernatants from trophoblast-activated peripheral blood mononuclear cells from all participants were tested for toxic effects on mouse embryos and by enzyme-linked immunosorbent assay (ELISA) for interferon gamma (IFN-gamma). Supernatants from 20 URA patients with embryotoxic activity and IFN-gamma, 13 reproductively normal parous women, and 10 men were further tested by ELISA for other T(H)1-type cytokines (interleukin-2 [IL-2], tumor necrosis factor-beta [TNF-beta]), T(H)2-type cytokines (IL-4, IL-10), and TNF-alpha. Results.-Embryotoxic activity was detected in supernatants from 160 of 244 URA patients and in none of the controls. Interferon gamma was detected in supernatants from 125 of 244 URA patients and was significantly associated with embryotoxicity (121 of 160 supernatants with embryotoxicity vs four of 84 supernatants without embryotoxicity [P<.001]). Of 20 supernatants from patients chosen for further study, all were positive for TNF-alpha, 17 for TNF-beta, two for IL-10, and one for IL-4, No cytokines were detected in supernatants from unstimulated or red blood cell membrane-activated cells of women with URA. In contrast, trophoblast-activated lymphocyte supernatants from reproductively normal women and men neither were embryotoxic nor contained T(H)1-type cytokines, but most contained the T(H)2-type cytokine IL-10. Three supernatants from reproductively normal women also contained IL-4. Conclusion.-Whereas T(H)1-type immunity to trophoblast is associated with URA and may play a role in reproductive failure, T(H)2-type immunity may be a natural response to trophoblast contributing to successful pregnancy.
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页码:1933 / 1936
页数:4
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