Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, trad...Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, traditional Chinese medicine has become a feasible alternative for certain diseases, including recurrent spontaneous abortion. However, because of the complex composition of the traditional Chinese medicine formula, its action mechanism remains unclear. Methods: We selected two isolated active ingredients (RAMP and baicalin) from the traditional Chinese medicine formula and used an abortion-prone CBA/J × DBA/2 model to simulate human RSA and compared the changes in fetal resorption rate, Treg cell percentage, and relevant cytokines before and after combination therapy. In addition, The mechanisms were preliminarily discussed using in vitro differentiation models. Results: In CBA/J × DBA/2 abortion-prone mice, the combination therapy resulted in a lower embryo resorption rate compared to that obtained with individual delivery of either RAMP or baicalin, thereby playing an embryo-protective role through the increase in Treg cells for the maintenance of maternal-fetal immune tolerance. In in vitro primary cell differentiation experiments, the concentration of Treg cells significantly increased from 11% to 17.9% after the combination therapy compared to that of the single administration group. Conclusion: the synergistic effects of RAMP and baicalin were responsible for Treg differentiation. The present study provides a solid basis for improving the applicability of traditional Chinese herbs in the treatment of recurrent spontaneous abortion.展开更多
Recurrent spontaneous abortion (RSA) is a complex and heterogeneous disorder with multiple etiologies. Genetic factors are thought to play an important role in the etiology of RSA. With recent advances in genetic test...Recurrent spontaneous abortion (RSA) is a complex and heterogeneous disorder with multiple etiologies. Genetic factors are thought to play an important role in the etiology of RSA. With recent advances in genetic testing technologies, there has been an increasing interest in using these tools to diagnose the etiology of RSA. This review discusses the different types of genetic testing methods, such as karyotyping, chromosomal microarray analysis, next-generation sequencing, and their applications in the diagnosis of the etiology RSA. The use of genetic testing in the diagnosis of RSA has the potential to improve the accuracy of diagnosis and the understanding of the underlying mechanisms of the disorder, which could lead to better management and treatment of affected individuals.展开更多
Recurrent spontaneous abortion is a common disease in gynecology,and it seriously affects women's reproductive health and brings heavy burden and pain to society and families.The cause of recurrent spontaneous abo...Recurrent spontaneous abortion is a common disease in gynecology,and it seriously affects women's reproductive health and brings heavy burden and pain to society and families.The cause of recurrent spontaneous abortion is complicated,in addition to the well-defined genetic,anatomical,infection and endocrine factors,and there are still some unknown causes,which is called as unexplained recurrent spontaneous abortion,accounting for 40%of recurrent abortion.At present,there are a lot of researches on the treatment methods of the patients with the unexplained recurrent spontaneous abortion,which also shows that the treatment of traditional Chinese and Western medicine all have certain clinical application effect.Western medicine clinical methods mainly includes immunotherapy,immunosuppressive therapy,anticoagulation therapy,progesterone therapy,etc.Based on the experience of the professor and combined with many years of clinical practice,the author believes that the pathogenesis of this disease in traditional Chinese medicine is mainly due to impaired impulse and deficiency of Spleen,lack of qi and blood,can not nourishing the fetus;deficiency of Kidney Qi,blood flow was delayed,and blood stasis and could not raise the fetus.Clinical treatment is based on invigorating the kidney,tonifying spleen and nourishing blood,promoting blood circulation to remove blood stasis and dredging collaterals.Oral Chinese medicine combined with external acupuncture and moxibustion has achieved excellent effects in improving pregnancy rate.This article reviews the domestic and foreign methods of treating unexplained recurrent miscarriage in order to provide clinical reference.In the future,the combination of Chinese and Western medicine should become the main therapy to increase pregnancy rate.展开更多
Objective:To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion(RSA)due to prethrombotic state(PTS).Methods:Databases such as CNKI,WanFang,VIP,CBM,Pu...Objective:To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion(RSA)due to prethrombotic state(PTS).Methods:Databases such as CNKI,WanFang,VIP,CBM,PubMed,Embase,and Cochrane Library were searched for randomized controlled trials on Bushen Huoxue prescription in treating RSA due to PTS from inception to March 2021;meta-analysis was performed by RevMan Version 5.3.0 following quality evaluation.Results:Seven trials were included,with 496 patients;the meta-analysis indicated that Bushen Huoxue prescription has advantages on the improvement of total clinical effective rate[RR=1.22,95%CI(1.10,1.35),Z=3.80(P=0.0001)],embryo survival rate at pregnancy of 12 weeks[RR=1.25,95%CI(1.10,1.41),Z=3.53(P=0.0004)],D-dimer levels[SMD=-1.59,95%CI(-2.20,-0.97),Z=5.07(P<0.00001)],and fibrinogen levels[MD=-1.00,95%CI(-1.29,-0.70),Z=6.61(P<0.00001)],but the statistical heterogeneity was significant;in terms of incidence of adverse reactions,there was no statistical difference between Bushen Huoxue prescription and western medicine.Conclusion:Compared with western medicine alone,Bushen Huoxue prescription alone or in combination with western medicine showed significant advantages in improving the overall clinical efficiency,embryonic survival rate at 12 weeks of pregnancy,and reducing D-dimer values as well as fibrinogen levels,without any significant difference in the incidence of adverse effects;however,the number of included studies is small and there are drawbacks,such as small sample size and low quality;therefore,high-quality clinical studies with large sample size and rigorous trial designs are needed in the future to provide a reliable basis for the effectiveness and safety of TCM in reducing the incidence of RSA due to prethrombotic state.展开更多
Piwi-interacting RNAs(piRNAs)is a novel class of non-coding RNAs.However,changes in piRNA expression profiles in recurrent spontaneous abortion(RSA)have not yet been investigated.The aim of this study was to identify ...Piwi-interacting RNAs(piRNAs)is a novel class of non-coding RNAs.However,changes in piRNA expression profiles in recurrent spontaneous abortion(RSA)have not yet been investigated.The aim of this study was to identify differentially expressed piRNAs in deciduas of RSA patients.Decidua tissues were collected by curettage from recruited RSA patients and normal early pregnant(NEP)women with their informed consent.Small RNA sequencing was used to evaluate the differences in piRNA expression profiles between RSA and NEP.The present results demonstrated that the counts of total piRNA reads in RSA samples were increased compared with those in NEP samples(0.21%vs.0.11%).Differential expression analysis identified 29 upregulated piRNAs and 18 downregulated piRNAs in RSA samples.RT-qPCR further confirmed that the expression levels of uniq-109625,uniq-89328,uniq-50651 and uniq-4569 were decreased in 8 RSA tissues,compared with 13 NEP tissues.Otherwise,pi-22628 and uniq-173406 were increased in 8 RSA tissues.Based on GO term and KEGG pathway analysis,we speculate that these piRNAs regulate RSA by targeting extracellular matrix component pathway,cell adhesion pathway and focal adhesion pathway.PiRNAs may be involved in RSA pathogenesis by target genes function on adhesion and extracellular matrix component.展开更多
Objective:To investigate the association between forkhead box P3(FOXP3)(rs3761548)polymorphism and the risk of preeclampsia and recurrent spontaneous abortion.Methods:Literature on the association of FOXP3 gene polymo...Objective:To investigate the association between forkhead box P3(FOXP3)(rs3761548)polymorphism and the risk of preeclampsia and recurrent spontaneous abortion.Methods:Literature on the association of FOXP3 gene polymorphisms and susceptibility to preeclampsia and unexplained recurrent spontaneous abortion was retrieved by searching databases such as PubMed,Science Direct,Google Scholar and Embase from 2000 to 2021.The association measure was analyzed using an odds ratio(OR)and 95%confidence interval(CI).All the statistical analyses were executed using RevMan 5.4 software.Results:In the present meta-analysis,11 articles were analyzed.The pooled results showed no association between FOXP3 gene polymorphism(rs3761548)and preeclampsia risk in allelic,recessive,dominant and over dominant contrast models.FOXP3 gene polymorphism(rs3761548)showed an association with recurrent abortion in allelic,recessive and dominant models(OR 1.85,CI 1.59-2.14;OR 2.02,95%CI 1.56-2.62;OR 2.69,95%CI 1.50-4.83,respectively),while no association in the over dominant contrast model(OR 1.35,CI 0.87-2.10).Conclusions:In the present study,FOXP3 gene(rs3761548)polymorphism is associated with risk of recurrent spontaneous abortion but not preeclampsia.However,larger sample size and multiracial studies are needed in the future to confirm the findings.展开更多
Objective: To investigate the correlation between recurrent spontaneous abortion patients and brain derived neurotrophic factor BDNF gene polymorphism and the mechanism of BDNF and recurrent spontaneous abortion under...Objective: To investigate the correlation between recurrent spontaneous abortion patients and brain derived neurotrophic factor BDNF gene polymorphism and the mechanism of BDNF and recurrent spontaneous abortion under stress state in order to provide theoretical basis for nursing psychological intervention of patients with recurrent abortion. Methods: Medical coping Questionnaire (MCMO) and post-traumatic stress Diagnostic Scale (POST-traumatic stress Scale) were adopted Dissorder (PTSD) (PCL-c) scale was used to diagnose the psychological stress of recurrent spontaneous abortion in our hospital, and the BDNF gene polymorphism and the correlation factors of METHYLation in BDNF promoter region were studied in 30 cases (control group) and normal control group. Results: The MCMQ score of the case group and the control group was significantly lower than that of the conventional group (P Conclusion: There are significant differences in PTSD between the case group and the control group, which are related to methylation in the PROMOTER region of BDNF and SNP g-712A of BDNF gene. AG patients in the case group are more susceptible to anxiety and depression, and GG PTSD is more severe in the case group. BDNF promoter methylation and G-712A were independent risk factors for PTSD in the case group.展开更多
Objective:To explore immunotherapy effectiveness of the CD4^(+)CD25^(+) regulatory T cells for treating female mouse with recurrent spontaneous abortion(RSA)by animal experiments.Methods:Mononuclear lymphocytes were i...Objective:To explore immunotherapy effectiveness of the CD4^(+)CD25^(+) regulatory T cells for treating female mouse with recurrent spontaneous abortion(RSA)by animal experiments.Methods:Mononuclear lymphocytes were isolated from the blood(instead of cord blood)of new-born baby of KunMing Bai mouse or BALB/c male mouse with normal birth ability(as unrelated third party blood source)by density gradient centrifuga-tion method.The CD4^(+)CD25^(+) regulatory T cells were selected by magnetic-activated cell sorting from mononuclear cells of cord blood cells.CBA/J female mouse copulated with DBA/2J male mouse was utilized as RSA animal model.Pregnant RSA mice were injected different types of lymphocytes through tail vein.Independent sample t-test was used to analyze the data from each group.Results:The proportion of CD4^(+)CD25^(+)T cells in CD4^(+)T cells was(17.49±0.60)%in CD4^(+)CD25^(+) regulatory T cells injection group,which was statistical significant higher than that of mononuclear lymphocyte injection group(14.68±0.83)%,sterile PBS group(9.54±0.85)%or no injection group(9.28±0.68)%(p<.05,t-value was 4.754,13.242 and 15.621,respec-tively).The Foxp3 relative protein expression level of CD4^(+)CD25^(+) regulatory T cells injected group was 5.85±0.45,which was also significant higher than that of mononuclear lymphocyte injection(2.86±0.54),sterile PBS group(1.08±0.16)or no injection group(1.00±0.00)(p<.05,t-value was 7.276,17.227 and 18.635,respectively).Finally,two times of CD4^(+)CD25^(+)T cell injected group at the 4 th and 8 th day had well effect for RSA mouse,and embryo sorption rate was(4.92±0.08)%,which significant lower than that of two times of mononuclear lymphocyte injected group(13.07±0.06)%,sterile PBS group(23.11±0.12)%,or no injection group(25.47±0.11)%(p<.05,t-value was-2.603,-4.012 and-4.700,respectively).Conclusions:Pregnant mouse with RSA injected CD4^(+)CD25^(+)T cells several times for immunotherapy can get better effec-tiveness than that of pregnant mouse injected traditional mononuclear cells.展开更多
The relationship between T cell immunoglobulin domain and mucin domain protein 3(Tim-3)/Galectin(Gal)-9 pathway and recurrent spontaneous abortion(RSA) was studied. Thirty-one pregnant women with RSA and 27 normal ear...The relationship between T cell immunoglobulin domain and mucin domain protein 3(Tim-3)/Galectin(Gal)-9 pathway and recurrent spontaneous abortion(RSA) was studied. Thirty-one pregnant women with RSA and 27 normal early gravidas were investigated to detect the levels of Tim-3 and Gal-9 in villi and deciduas by Western blotting. Meanwhile, the concentration of interleukin(IL)-4 and IL-12 in peripheral blood plasma was determined by ELISA in 25 healthy fertile non-pregnant controls, the normal early gravidas and pregnant women with RSA mentioned above, respectively. It was found that the relative expression levels of Tim-3 and Gal-9 in villi and deciduas were significantly increased in pregnant women with RSA as compared with those in the normal early gravidas. The concentration of IL-4 in peripheral blood plasma of pregnant women with RSA was lower than that of the normal early gravidas(P<0.05) and healthy fertile non-pregnant controls(P<0.05), but that of IL-2 in pregnant women with RSA was significantly higher than that of the normal early gravidas(P<0.05) and healthy fertile non-pregnant controls(P<0.05). It was suggested that the overexpression of Tim-3/Gal-9 pathway may be related to the pathogenesis of RSA.展开更多
p53 gene plays an important role in apoptosis, which is necessary for successful invasion of trophoblast cells. The change from an arginine(Arg) to a proline(Pro) at codon 72 can influence the biological activity of p...p53 gene plays an important role in apoptosis, which is necessary for successful invasion of trophoblast cells. The change from an arginine(Arg) to a proline(Pro) at codon 72 can influence the biological activity of p53, which predisposes to an increased risk of recurrent spontaneous abortion(RSA). In order to investigate the association between p53 polymorphism at codon 72 and RSA, we conducted this meta-analysis. Pubmed, Embase and Web of science were used to identify the eligible studies. Odds ratio(OR) with 95% confidence interval(CI) was used to evaluate the strength of the association. Six studies containing 937 cases of RSA and 830 controls were included, and there was one study deviated from Hardy-Weinberg equilibrium(HWE). There was a significant association between p53 polymorphism at codon 72 and RSA in recessive model(Pro/Pro vs. Pro/Arg+Arg/Arg; OR=1.60, 95% CI: 1.14–2.24) and co-dominant model(Pro/Pro vs. Arg/Arg; OR=1.47, 95% CI: 1.02–2.12) whether the study that was deviated from HWE was eliminated or not. A significant association was observed in allelic model(Pro vs. Arg; OR=1.28, 95% CI: 1.04–1.57) after exclusion of the study that was deviated from HWE. No association was noted in recessive model(Pro/Pro+Pro/Arg vs. Arg/Arg; OR=1.05, 95% CI: 0.86–1.30) and co-dominant model(Pro/Arg vs. Arg/Arg; OR=0.96, 95% CI: 0.77–1.19). Subgroup analysis by ethnicity also indicated a significant association between p53 polymorphism at codon 72 and RSA in Caucasian group. No heterogeneity and publication bias were found. Our meta-analysis implied that p53 polymorphism at codon 72 carries high maternal risk of RSA.展开更多
Objective:To study the correlation of Th1/Th2 balance in peripheral blood with cell apoptosis and invasion in decidual tissue in patients with recurrent spontaneous abortion (RSA). Methods: The subjects who were diagn...Objective:To study the correlation of Th1/Th2 balance in peripheral blood with cell apoptosis and invasion in decidual tissue in patients with recurrent spontaneous abortion (RSA). Methods: The subjects who were diagnosed with recurrent spontaneous abortion in Xiangyang Central Hospital between February 2015 and December 2017 were chosen as the RSA group, and the subjects who received early induced abortion in Xiangyang Central Hospital during the same period were chosen as the control group. The contents of Th1/Th2 cytokines and the expression of transcription factors in peripheral blood as well as the expression of apoptosis genes and invasion genes in decidual tissue were determined.Results: IL-2 and IFN-γ contents and T-bet expression in peripheral blood as well as CRT, Bax, Caspase-3, RECK and IL-1β mRNA expression in decidual tissue of RSA group were significantly higher than those of control group whereas IL-4 and IL-10 contents and GATA-3 expression in peripheral blood as well as HJURP, Bcl-2, HLA-G, MMP2, MMP9 and HOXA10 mRNA expression in decidual tissue were significantly lower than those of control group;IL-2 and IFN-γ contents as well as T-bet expression in peripheral blood of RSA group were negatively correlated with HJURP, Bcl-2, HLA-G, MMP2, MMP9 and HOXA10 mRNA expression in decidual tissue, and positively correlated with CRT, Bax, Caspase-3, RECK and IL-1β mRNA expression;IL-4 and IL-10 contents as well as GATA-3 expression in peripheral blood were positively correlated with HJURP, Bcl-2, HLA-G, MMP2, MMP9 and HOXA10 mRNA expression in decidual tissue, and negatively correlated with CRT, Bax, Caspase-3, RECK and IL-1β mRNA expression.Conclusion: The shift of Th1/Th2 balance to Th1 in peripheral blood of RSA patients may result in increased apoptosis and inhibited cell invasion in decidual tissues.展开更多
Introduction: Spontaneous abortion is defined as pregnancy loss before the twentieth week and Recurrent Spontaneous Abortion (RSA) is defined as at least three spontaneous and successive pregnancy losses in the s...Introduction: Spontaneous abortion is defined as pregnancy loss before the twentieth week and Recurrent Spontaneous Abortion (RSA) is defined as at least three spontaneous and successive pregnancy losses in the same period. Among the different types of immunological causes, this study refers specifically to the alloimmune cause. Women with RSA of alloimmune cause share a greater number of Human Leukocyte Antigen (HLA) with their husbands, leading to the inhibition of the production of anti-paternal asymmetric blocking antibodies, which would protect embryonic cells. Objectives: To evaluate the effect of immunotherapy with paternal HLA-sensitizing mononuclear cells in cases of RSA through the positivity of the cross-match test and its efficacy in pregnancy success. Patients and Methods: Written consent was obtained, 12 couples with a history of RSA presenting negative cross-match were included in the study. Blood samples were collected from the couple for cross-matching and the separation of paternal mononuclear cells. Immunotherapy was performed with paternal mononuclear cells intradermally in the wives’ arms on day (D) 0, D15 and D30. After the third dose, a second evaluation of the cross- match tests was performed. Results and Discussion: The age of the wives ranged from 28 to 41 years, with a mean of 34.5 years. The twelve couples had a negative cross-match test (100%). Eleven couples (96.6%) tested positive in the cross- match test after immunotherapy. Of these, 10 (90.9%) had successful pregnancies. Immunotherapy with paternal mononuclear cells showed an excellent ability to sensitize the maternal immune system, with positive cross-match, resulting in a successful pregnancy.展开更多
Objective To investigate the effect of active immunotherapy on unexplained recurrent sponta- neous abortion(URSA)during the process of gestation and delivery period. Methods We collected the data of the women with URS...Objective To investigate the effect of active immunotherapy on unexplained recurrent sponta- neous abortion(URSA)during the process of gestation and delivery period. Methods We collected the data of the women with URSA and their offsprings. The women were treated by immunization with paternal lymphocytes and then had a successful pregnancy. The fore mentioned group of women were compared with those who had a normal pregnancy and then delivered in the same period. Results The incidences of premature rupture of membranes, adherent placenta, and residual cauls in the group of URSA patients were statistically higher than those in the normal group. Correspondingly, gestational age at delivery and birth weight of the newborns of the group of URSA patients were lower, but there were no significant differences between the two groups . Conclusion These results indicate that paternal lymphocyte immunotherapy is effective on the maintenance of pregnancy in women with URSA, and has no deleterious effects on the fetus or newborns. However, in case of the higher incidence of premature rupture of membranes, adher- ent placenta, and residual cauls, more attention should be paid to the treated patients to avoid intrauterine growth retardation and postpartum hemorrhage.展开更多
Objective: To study the correlation of apoptosis with invasion and angiogenesis in decidual tissue of recurrent spontaneous abortion (RSA). Methods: Patients with recurrent spontaneous abortion who were treated in Zig...Objective: To study the correlation of apoptosis with invasion and angiogenesis in decidual tissue of recurrent spontaneous abortion (RSA). Methods: Patients with recurrent spontaneous abortion who were treated in Zigong Maternity and Child Healthcare Hospital between July 2014 and March 2017 were selected as the RSA group of the research, and the pregnant women who were with spontaneous labor in Zigong Maternity and Child Healthcare Hospital during the same period and without history of abortion were selected as the control group of the research. Decidualtissue was collected to determine the mRNA expression of apoptosis genes and invasion genes as well as the protein levels of pro-angiogenesis molecules, and the serum was collected to determine the protein levels of anti-angiogenesis molecules. Results: Bcl-2 mRNA expression in decidual tissue of RSA group was significantly lower than that of control group while Bax, Caspase-3, Caspase-9 and TRAIL mRNA expression were significantly higher than those of control group;MMP2 and MMP9 mRNA expression as well as VEGF, Ang-1, Ang-2 and Tie-2 protein levels in decidual tissue of RSA group were significantly lower than those of control group, positively correlated with Bcl-2 mRNA expression, and negatively correlated with Bax, Caspase-3, Caspase-9 and TRAIL mRNA expression;TIMP1 and TIMP2 mRNA expression in decidual tissue as well as sFlt-1 protein level in serum were significantly higher than those of control group, negatively correlated with Bcl-2 mRNA expression, and positively correlated with Bax, Caspase-3, Caspase-9 and TRAIL mRNA expression. Conclusion: Pro-apoptosis gene expression increases and anti-apoptosis gene expression increases in decidual tissue of RSA, and the excessive apoptosis is related to the insufficiency of invasion and the decrease of angiogenesis.展开更多
Objective:To test the hypothesis that peripheral blood mononuclear cells (PBMCs) in women with unexplained recurrent abortion (URA) produce T-helper 1 (Th1)-type cytokines in response to trophoblast antigens. Methods:...Objective:To test the hypothesis that peripheral blood mononuclear cells (PBMCs) in women with unexplained recurrent abortion (URA) produce T-helper 1 (Th1)-type cytokines in response to trophoblast antigens. Methods: A total of 25 women with URA and 15 reproductively normal parous control women participated the study. Supernatants from trophoblast-activatied PBMCs from all participants were tested by enzyme-linked immunosorbent assay(ELISA) for Th1-type cytokines [interleukin-2 (IL-2), interferon gamma (IFN-γ)] and Th2-type cytokines (IL-4,IL-10). Results: The levels of IL-2, IFN-γ in trophoblast-activitated PBMCs supernatants from URA patients were highr than those from reproductively normal women (P<0.05). In contrast, the supernatants from URA patients contained lower Th2-type cytokines (IL-4,IL- 10) (P<0.05). Conclusions: Whereas Th1-type immunity to trophoblast is assoicated with URA and may play a role in reproductive failure, Th2-type immunity may a natural response to trophoblast contributing to successful pregnancy.展开更多
The causes of recurrent spontaneous abortion are complex traditional Chinese medicine holds that its etiology is losses of spleen and kidney qi, qi and xue deficiency, in addition to secretion, genetic, anatomical, in...The causes of recurrent spontaneous abortion are complex traditional Chinese medicine holds that its etiology is losses of spleen and kidney qi, qi and xue deficiency, in addition to secretion, genetic, anatomical, infection, systemic diseases, environmental factors and other related immune factors, the deficiency of blocking antibody is also one of the reasons for the lack of immune factors. In treating it, Chinese medicine treatment combines the patients personal constitution and treatment based on syndrome differentiation; Western medicine treatment mainly applies Aspirin, active immune lymphocyte treatment, low molecular heparin, gamma globulin protein passive immune treatment and psychological intervention therapy. In this paper, a review of the treatment methods for closed antibodies in the past 5 years is made.展开更多
Objective:To analyze the proportion of peripheral regulatory T cells(Tregs)and the expression of the immune checkpoint molecules T-cell immunoglobulin and ITIM domain(TIGIT)and CD226 on Tregs in patients with recurren...Objective:To analyze the proportion of peripheral regulatory T cells(Tregs)and the expression of the immune checkpoint molecules T-cell immunoglobulin and ITIM domain(TIGIT)and CD226 on Tregs in patients with recurrent spontaneous abortion(RSA).Methods:The proportion of CD3+CD4+CD25+Foxp3+Tregs and the expression levels of CD226 and TIGIT on Tregs in 30 normal pregnant women and 28 patients with RSA were determined via flow cytometry.Results:The proportion of Tregs in the RSA group(4.41%±1.54%)was significantly lower than that in the control group(5.27%±1.52%,P=0.0374).Compared with the normal pregnant women,patients with RSA showed decreased TIGIT expression(54.75±9.70%vs.63.07±12.48%,P=0.0066)and increased CD226 expression on Tregs(25.59%±8.22%vs.20.46%±6.97%,P=0.0168).The ratio of CD226 to TIGIT in the RSA group(0.48±0.19)was higher than that in the control group(0.34±0.15,P=0.0027).The proportion of TIGIT+CD226+Tregs was significantly lower in patients with RSA(9.30%±4.95%vs.13.43%±4.72%,P=0.0020)than in the controls.Conclusions:Patients with RSA show a reduced proportion of Tregs and an imbalance in the expression of TIGIT and CD226 on Tregs.展开更多
Recurrent spontaneous abortion(RSA),defined as three or more consecutive pregnancy losses before 20 weeks of gestation,is difficult to treat in the clinical setting.It affects 1%–5%of women of reproductive age.In the...Recurrent spontaneous abortion(RSA),defined as three or more consecutive pregnancy losses before 20 weeks of gestation,is difficult to treat in the clinical setting.It affects 1%–5%of women of reproductive age.In the investigations of immunopathogenesis,diagnosis,and treatment of RSA since the late 1980s,it was found that RSA was associated with abnormal maternal local or systemic immune response.The pathogenesis of autoimmune RSA was mainly associated with antiphospholipid antibody(APA),while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance.Systemic etiological screening process and diagnosis systems of RSA with immune type were developed,and anticardiolipin(ACL or ACA)+anti-β2-GP1 antibody combining multiple assays for effective diagnosis of RSA with autoimmune type was first established.According to the dynamic monitoring of clinical parameters before and during gestation,low-dose,short-course,and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA with immune type were carried out.The outcomes of the offsprings of patients with RSA were followed up,and the safety and validity of the therapies were confirmed.The research achievement leads to great progress in the diagnosis and treatment of RSA in China.展开更多
基金the National Natural Science Foundation of China(81973221)National Natural Science Foundation for Young Scientists of China(81603647)+2 种基金the Women and Children Health Talent Project of Jiangsu Province(FRC201785)the Chinese Clinical Medicine Innovation Center of Obstetrics,Gynecology,and Reproduction in Jiangsu Province(ZX202102)the Women and Children Health Science Foundation of Jiangsu Province(F202206).
文摘Background: The absence of a safe and effective therapy for recurrent spontaneous abortion due to a maternofetal failure in immunological tolerance remains an intractable clinical obstacle for surgeons. Recently, traditional Chinese medicine has become a feasible alternative for certain diseases, including recurrent spontaneous abortion. However, because of the complex composition of the traditional Chinese medicine formula, its action mechanism remains unclear. Methods: We selected two isolated active ingredients (RAMP and baicalin) from the traditional Chinese medicine formula and used an abortion-prone CBA/J × DBA/2 model to simulate human RSA and compared the changes in fetal resorption rate, Treg cell percentage, and relevant cytokines before and after combination therapy. In addition, The mechanisms were preliminarily discussed using in vitro differentiation models. Results: In CBA/J × DBA/2 abortion-prone mice, the combination therapy resulted in a lower embryo resorption rate compared to that obtained with individual delivery of either RAMP or baicalin, thereby playing an embryo-protective role through the increase in Treg cells for the maintenance of maternal-fetal immune tolerance. In in vitro primary cell differentiation experiments, the concentration of Treg cells significantly increased from 11% to 17.9% after the combination therapy compared to that of the single administration group. Conclusion: the synergistic effects of RAMP and baicalin were responsible for Treg differentiation. The present study provides a solid basis for improving the applicability of traditional Chinese herbs in the treatment of recurrent spontaneous abortion.
文摘Recurrent spontaneous abortion (RSA) is a complex and heterogeneous disorder with multiple etiologies. Genetic factors are thought to play an important role in the etiology of RSA. With recent advances in genetic testing technologies, there has been an increasing interest in using these tools to diagnose the etiology of RSA. This review discusses the different types of genetic testing methods, such as karyotyping, chromosomal microarray analysis, next-generation sequencing, and their applications in the diagnosis of the etiology RSA. The use of genetic testing in the diagnosis of RSA has the potential to improve the accuracy of diagnosis and the understanding of the underlying mechanisms of the disorder, which could lead to better management and treatment of affected individuals.
基金National Natural Science Foundation of China(No.81973894)。
文摘Recurrent spontaneous abortion is a common disease in gynecology,and it seriously affects women's reproductive health and brings heavy burden and pain to society and families.The cause of recurrent spontaneous abortion is complicated,in addition to the well-defined genetic,anatomical,infection and endocrine factors,and there are still some unknown causes,which is called as unexplained recurrent spontaneous abortion,accounting for 40%of recurrent abortion.At present,there are a lot of researches on the treatment methods of the patients with the unexplained recurrent spontaneous abortion,which also shows that the treatment of traditional Chinese and Western medicine all have certain clinical application effect.Western medicine clinical methods mainly includes immunotherapy,immunosuppressive therapy,anticoagulation therapy,progesterone therapy,etc.Based on the experience of the professor and combined with many years of clinical practice,the author believes that the pathogenesis of this disease in traditional Chinese medicine is mainly due to impaired impulse and deficiency of Spleen,lack of qi and blood,can not nourishing the fetus;deficiency of Kidney Qi,blood flow was delayed,and blood stasis and could not raise the fetus.Clinical treatment is based on invigorating the kidney,tonifying spleen and nourishing blood,promoting blood circulation to remove blood stasis and dredging collaterals.Oral Chinese medicine combined with external acupuncture and moxibustion has achieved excellent effects in improving pregnancy rate.This article reviews the domestic and foreign methods of treating unexplained recurrent miscarriage in order to provide clinical reference.In the future,the combination of Chinese and Western medicine should become the main therapy to increase pregnancy rate.
基金National Natural Science Foundation of China Project(Project Number:81603656)Shaanxi University of Traditional Chinese Medicine 2017 Annual Scientific Research Program Project(Project Number:2017PY10)Infertility Innovation Team(Project Number:132041929).
文摘Objective:To evaluate the effectiveness and safety of Bushen Huoxue prescription in the treatment of recurrent spontaneous abortion(RSA)due to prethrombotic state(PTS).Methods:Databases such as CNKI,WanFang,VIP,CBM,PubMed,Embase,and Cochrane Library were searched for randomized controlled trials on Bushen Huoxue prescription in treating RSA due to PTS from inception to March 2021;meta-analysis was performed by RevMan Version 5.3.0 following quality evaluation.Results:Seven trials were included,with 496 patients;the meta-analysis indicated that Bushen Huoxue prescription has advantages on the improvement of total clinical effective rate[RR=1.22,95%CI(1.10,1.35),Z=3.80(P=0.0001)],embryo survival rate at pregnancy of 12 weeks[RR=1.25,95%CI(1.10,1.41),Z=3.53(P=0.0004)],D-dimer levels[SMD=-1.59,95%CI(-2.20,-0.97),Z=5.07(P<0.00001)],and fibrinogen levels[MD=-1.00,95%CI(-1.29,-0.70),Z=6.61(P<0.00001)],but the statistical heterogeneity was significant;in terms of incidence of adverse reactions,there was no statistical difference between Bushen Huoxue prescription and western medicine.Conclusion:Compared with western medicine alone,Bushen Huoxue prescription alone or in combination with western medicine showed significant advantages in improving the overall clinical efficiency,embryonic survival rate at 12 weeks of pregnancy,and reducing D-dimer values as well as fibrinogen levels,without any significant difference in the incidence of adverse effects;however,the number of included studies is small and there are drawbacks,such as small sample size and low quality;therefore,high-quality clinical studies with large sample size and rigorous trial designs are needed in the future to provide a reliable basis for the effectiveness and safety of TCM in reducing the incidence of RSA due to prethrombotic state.
基金Supported by the National Natural Science Foundation of China Grants(No.81801523)the Natural Science Foundation of Guangdong Province(Nos.2017A030313789,2018A030313528,2019A1515011984)+3 种基金the Science and Technology Planning Foundation of Guangzhou City(201904010017,202102080102)Guangdong Province Medical Research Funding(No.A2021269)the Family Planning Research Institute Innovation Team of Guangdong Province grants(C-03)the Family Planning Research Institute of Guangdong Province Grants(S2018010).
文摘Piwi-interacting RNAs(piRNAs)is a novel class of non-coding RNAs.However,changes in piRNA expression profiles in recurrent spontaneous abortion(RSA)have not yet been investigated.The aim of this study was to identify differentially expressed piRNAs in deciduas of RSA patients.Decidua tissues were collected by curettage from recruited RSA patients and normal early pregnant(NEP)women with their informed consent.Small RNA sequencing was used to evaluate the differences in piRNA expression profiles between RSA and NEP.The present results demonstrated that the counts of total piRNA reads in RSA samples were increased compared with those in NEP samples(0.21%vs.0.11%).Differential expression analysis identified 29 upregulated piRNAs and 18 downregulated piRNAs in RSA samples.RT-qPCR further confirmed that the expression levels of uniq-109625,uniq-89328,uniq-50651 and uniq-4569 were decreased in 8 RSA tissues,compared with 13 NEP tissues.Otherwise,pi-22628 and uniq-173406 were increased in 8 RSA tissues.Based on GO term and KEGG pathway analysis,we speculate that these piRNAs regulate RSA by targeting extracellular matrix component pathway,cell adhesion pathway and focal adhesion pathway.PiRNAs may be involved in RSA pathogenesis by target genes function on adhesion and extracellular matrix component.
文摘Objective:To investigate the association between forkhead box P3(FOXP3)(rs3761548)polymorphism and the risk of preeclampsia and recurrent spontaneous abortion.Methods:Literature on the association of FOXP3 gene polymorphisms and susceptibility to preeclampsia and unexplained recurrent spontaneous abortion was retrieved by searching databases such as PubMed,Science Direct,Google Scholar and Embase from 2000 to 2021.The association measure was analyzed using an odds ratio(OR)and 95%confidence interval(CI).All the statistical analyses were executed using RevMan 5.4 software.Results:In the present meta-analysis,11 articles were analyzed.The pooled results showed no association between FOXP3 gene polymorphism(rs3761548)and preeclampsia risk in allelic,recessive,dominant and over dominant contrast models.FOXP3 gene polymorphism(rs3761548)showed an association with recurrent abortion in allelic,recessive and dominant models(OR 1.85,CI 1.59-2.14;OR 2.02,95%CI 1.56-2.62;OR 2.69,95%CI 1.50-4.83,respectively),while no association in the over dominant contrast model(OR 1.35,CI 0.87-2.10).Conclusions:In the present study,FOXP3 gene(rs3761548)polymorphism is associated with risk of recurrent spontaneous abortion but not preeclampsia.However,larger sample size and multiracial studies are needed in the future to confirm the findings.
文摘Objective: To investigate the correlation between recurrent spontaneous abortion patients and brain derived neurotrophic factor BDNF gene polymorphism and the mechanism of BDNF and recurrent spontaneous abortion under stress state in order to provide theoretical basis for nursing psychological intervention of patients with recurrent abortion. Methods: Medical coping Questionnaire (MCMO) and post-traumatic stress Diagnostic Scale (POST-traumatic stress Scale) were adopted Dissorder (PTSD) (PCL-c) scale was used to diagnose the psychological stress of recurrent spontaneous abortion in our hospital, and the BDNF gene polymorphism and the correlation factors of METHYLation in BDNF promoter region were studied in 30 cases (control group) and normal control group. Results: The MCMQ score of the case group and the control group was significantly lower than that of the conventional group (P Conclusion: There are significant differences in PTSD between the case group and the control group, which are related to methylation in the PROMOTER region of BDNF and SNP g-712A of BDNF gene. AG patients in the case group are more susceptible to anxiety and depression, and GG PTSD is more severe in the case group. BDNF promoter methylation and G-712A were independent risk factors for PTSD in the case group.
文摘Objective:To explore immunotherapy effectiveness of the CD4^(+)CD25^(+) regulatory T cells for treating female mouse with recurrent spontaneous abortion(RSA)by animal experiments.Methods:Mononuclear lymphocytes were isolated from the blood(instead of cord blood)of new-born baby of KunMing Bai mouse or BALB/c male mouse with normal birth ability(as unrelated third party blood source)by density gradient centrifuga-tion method.The CD4^(+)CD25^(+) regulatory T cells were selected by magnetic-activated cell sorting from mononuclear cells of cord blood cells.CBA/J female mouse copulated with DBA/2J male mouse was utilized as RSA animal model.Pregnant RSA mice were injected different types of lymphocytes through tail vein.Independent sample t-test was used to analyze the data from each group.Results:The proportion of CD4^(+)CD25^(+)T cells in CD4^(+)T cells was(17.49±0.60)%in CD4^(+)CD25^(+) regulatory T cells injection group,which was statistical significant higher than that of mononuclear lymphocyte injection group(14.68±0.83)%,sterile PBS group(9.54±0.85)%or no injection group(9.28±0.68)%(p<.05,t-value was 4.754,13.242 and 15.621,respec-tively).The Foxp3 relative protein expression level of CD4^(+)CD25^(+) regulatory T cells injected group was 5.85±0.45,which was also significant higher than that of mononuclear lymphocyte injection(2.86±0.54),sterile PBS group(1.08±0.16)or no injection group(1.00±0.00)(p<.05,t-value was 7.276,17.227 and 18.635,respectively).Finally,two times of CD4^(+)CD25^(+)T cell injected group at the 4 th and 8 th day had well effect for RSA mouse,and embryo sorption rate was(4.92±0.08)%,which significant lower than that of two times of mononuclear lymphocyte injected group(13.07±0.06)%,sterile PBS group(23.11±0.12)%,or no injection group(25.47±0.11)%(p<.05,t-value was-2.603,-4.012 and-4.700,respectively).Conclusions:Pregnant mouse with RSA injected CD4^(+)CD25^(+)T cells several times for immunotherapy can get better effec-tiveness than that of pregnant mouse injected traditional mononuclear cells.
基金supported by grants from the National Science Foundation of China(Nos.30973205 and 81172464)the National "Twelfth-Five Year" Research and Development Program of China(No.2014BAI05B05)
文摘The relationship between T cell immunoglobulin domain and mucin domain protein 3(Tim-3)/Galectin(Gal)-9 pathway and recurrent spontaneous abortion(RSA) was studied. Thirty-one pregnant women with RSA and 27 normal early gravidas were investigated to detect the levels of Tim-3 and Gal-9 in villi and deciduas by Western blotting. Meanwhile, the concentration of interleukin(IL)-4 and IL-12 in peripheral blood plasma was determined by ELISA in 25 healthy fertile non-pregnant controls, the normal early gravidas and pregnant women with RSA mentioned above, respectively. It was found that the relative expression levels of Tim-3 and Gal-9 in villi and deciduas were significantly increased in pregnant women with RSA as compared with those in the normal early gravidas. The concentration of IL-4 in peripheral blood plasma of pregnant women with RSA was lower than that of the normal early gravidas(P<0.05) and healthy fertile non-pregnant controls(P<0.05), but that of IL-2 in pregnant women with RSA was significantly higher than that of the normal early gravidas(P<0.05) and healthy fertile non-pregnant controls(P<0.05). It was suggested that the overexpression of Tim-3/Gal-9 pathway may be related to the pathogenesis of RSA.
基金supported by The National Science and Technology Pillar of China program during the Twelfth Five-Year Plan Period(No.2014BAI 05B05)
文摘p53 gene plays an important role in apoptosis, which is necessary for successful invasion of trophoblast cells. The change from an arginine(Arg) to a proline(Pro) at codon 72 can influence the biological activity of p53, which predisposes to an increased risk of recurrent spontaneous abortion(RSA). In order to investigate the association between p53 polymorphism at codon 72 and RSA, we conducted this meta-analysis. Pubmed, Embase and Web of science were used to identify the eligible studies. Odds ratio(OR) with 95% confidence interval(CI) was used to evaluate the strength of the association. Six studies containing 937 cases of RSA and 830 controls were included, and there was one study deviated from Hardy-Weinberg equilibrium(HWE). There was a significant association between p53 polymorphism at codon 72 and RSA in recessive model(Pro/Pro vs. Pro/Arg+Arg/Arg; OR=1.60, 95% CI: 1.14–2.24) and co-dominant model(Pro/Pro vs. Arg/Arg; OR=1.47, 95% CI: 1.02–2.12) whether the study that was deviated from HWE was eliminated or not. A significant association was observed in allelic model(Pro vs. Arg; OR=1.28, 95% CI: 1.04–1.57) after exclusion of the study that was deviated from HWE. No association was noted in recessive model(Pro/Pro+Pro/Arg vs. Arg/Arg; OR=1.05, 95% CI: 0.86–1.30) and co-dominant model(Pro/Arg vs. Arg/Arg; OR=0.96, 95% CI: 0.77–1.19). Subgroup analysis by ethnicity also indicated a significant association between p53 polymorphism at codon 72 and RSA in Caucasian group. No heterogeneity and publication bias were found. Our meta-analysis implied that p53 polymorphism at codon 72 carries high maternal risk of RSA.
基金Youth Project of Natural Science Foundation of Hubei Province.Project No:2016CFB344.
文摘Objective:To study the correlation of Th1/Th2 balance in peripheral blood with cell apoptosis and invasion in decidual tissue in patients with recurrent spontaneous abortion (RSA). Methods: The subjects who were diagnosed with recurrent spontaneous abortion in Xiangyang Central Hospital between February 2015 and December 2017 were chosen as the RSA group, and the subjects who received early induced abortion in Xiangyang Central Hospital during the same period were chosen as the control group. The contents of Th1/Th2 cytokines and the expression of transcription factors in peripheral blood as well as the expression of apoptosis genes and invasion genes in decidual tissue were determined.Results: IL-2 and IFN-γ contents and T-bet expression in peripheral blood as well as CRT, Bax, Caspase-3, RECK and IL-1β mRNA expression in decidual tissue of RSA group were significantly higher than those of control group whereas IL-4 and IL-10 contents and GATA-3 expression in peripheral blood as well as HJURP, Bcl-2, HLA-G, MMP2, MMP9 and HOXA10 mRNA expression in decidual tissue were significantly lower than those of control group;IL-2 and IFN-γ contents as well as T-bet expression in peripheral blood of RSA group were negatively correlated with HJURP, Bcl-2, HLA-G, MMP2, MMP9 and HOXA10 mRNA expression in decidual tissue, and positively correlated with CRT, Bax, Caspase-3, RECK and IL-1β mRNA expression;IL-4 and IL-10 contents as well as GATA-3 expression in peripheral blood were positively correlated with HJURP, Bcl-2, HLA-G, MMP2, MMP9 and HOXA10 mRNA expression in decidual tissue, and negatively correlated with CRT, Bax, Caspase-3, RECK and IL-1β mRNA expression.Conclusion: The shift of Th1/Th2 balance to Th1 in peripheral blood of RSA patients may result in increased apoptosis and inhibited cell invasion in decidual tissues.
文摘Introduction: Spontaneous abortion is defined as pregnancy loss before the twentieth week and Recurrent Spontaneous Abortion (RSA) is defined as at least three spontaneous and successive pregnancy losses in the same period. Among the different types of immunological causes, this study refers specifically to the alloimmune cause. Women with RSA of alloimmune cause share a greater number of Human Leukocyte Antigen (HLA) with their husbands, leading to the inhibition of the production of anti-paternal asymmetric blocking antibodies, which would protect embryonic cells. Objectives: To evaluate the effect of immunotherapy with paternal HLA-sensitizing mononuclear cells in cases of RSA through the positivity of the cross-match test and its efficacy in pregnancy success. Patients and Methods: Written consent was obtained, 12 couples with a history of RSA presenting negative cross-match were included in the study. Blood samples were collected from the couple for cross-matching and the separation of paternal mononuclear cells. Immunotherapy was performed with paternal mononuclear cells intradermally in the wives’ arms on day (D) 0, D15 and D30. After the third dose, a second evaluation of the cross- match tests was performed. Results and Discussion: The age of the wives ranged from 28 to 41 years, with a mean of 34.5 years. The twelve couples had a negative cross-match test (100%). Eleven couples (96.6%) tested positive in the cross- match test after immunotherapy. Of these, 10 (90.9%) had successful pregnancies. Immunotherapy with paternal mononuclear cells showed an excellent ability to sensitize the maternal immune system, with positive cross-match, resulting in a successful pregnancy.
文摘Objective To investigate the effect of active immunotherapy on unexplained recurrent sponta- neous abortion(URSA)during the process of gestation and delivery period. Methods We collected the data of the women with URSA and their offsprings. The women were treated by immunization with paternal lymphocytes and then had a successful pregnancy. The fore mentioned group of women were compared with those who had a normal pregnancy and then delivered in the same period. Results The incidences of premature rupture of membranes, adherent placenta, and residual cauls in the group of URSA patients were statistically higher than those in the normal group. Correspondingly, gestational age at delivery and birth weight of the newborns of the group of URSA patients were lower, but there were no significant differences between the two groups . Conclusion These results indicate that paternal lymphocyte immunotherapy is effective on the maintenance of pregnancy in women with URSA, and has no deleterious effects on the fetus or newborns. However, in case of the higher incidence of premature rupture of membranes, adher- ent placenta, and residual cauls, more attention should be paid to the treated patients to avoid intrauterine growth retardation and postpartum hemorrhage.
文摘Objective: To study the correlation of apoptosis with invasion and angiogenesis in decidual tissue of recurrent spontaneous abortion (RSA). Methods: Patients with recurrent spontaneous abortion who were treated in Zigong Maternity and Child Healthcare Hospital between July 2014 and March 2017 were selected as the RSA group of the research, and the pregnant women who were with spontaneous labor in Zigong Maternity and Child Healthcare Hospital during the same period and without history of abortion were selected as the control group of the research. Decidualtissue was collected to determine the mRNA expression of apoptosis genes and invasion genes as well as the protein levels of pro-angiogenesis molecules, and the serum was collected to determine the protein levels of anti-angiogenesis molecules. Results: Bcl-2 mRNA expression in decidual tissue of RSA group was significantly lower than that of control group while Bax, Caspase-3, Caspase-9 and TRAIL mRNA expression were significantly higher than those of control group;MMP2 and MMP9 mRNA expression as well as VEGF, Ang-1, Ang-2 and Tie-2 protein levels in decidual tissue of RSA group were significantly lower than those of control group, positively correlated with Bcl-2 mRNA expression, and negatively correlated with Bax, Caspase-3, Caspase-9 and TRAIL mRNA expression;TIMP1 and TIMP2 mRNA expression in decidual tissue as well as sFlt-1 protein level in serum were significantly higher than those of control group, negatively correlated with Bcl-2 mRNA expression, and positively correlated with Bax, Caspase-3, Caspase-9 and TRAIL mRNA expression. Conclusion: Pro-apoptosis gene expression increases and anti-apoptosis gene expression increases in decidual tissue of RSA, and the excessive apoptosis is related to the insufficiency of invasion and the decrease of angiogenesis.
文摘Objective:To test the hypothesis that peripheral blood mononuclear cells (PBMCs) in women with unexplained recurrent abortion (URA) produce T-helper 1 (Th1)-type cytokines in response to trophoblast antigens. Methods: A total of 25 women with URA and 15 reproductively normal parous control women participated the study. Supernatants from trophoblast-activatied PBMCs from all participants were tested by enzyme-linked immunosorbent assay(ELISA) for Th1-type cytokines [interleukin-2 (IL-2), interferon gamma (IFN-γ)] and Th2-type cytokines (IL-4,IL-10). Results: The levels of IL-2, IFN-γ in trophoblast-activitated PBMCs supernatants from URA patients were highr than those from reproductively normal women (P<0.05). In contrast, the supernatants from URA patients contained lower Th2-type cytokines (IL-4,IL- 10) (P<0.05). Conclusions: Whereas Th1-type immunity to trophoblast is assoicated with URA and may play a role in reproductive failure, Th2-type immunity may a natural response to trophoblast contributing to successful pregnancy.
文摘The causes of recurrent spontaneous abortion are complex traditional Chinese medicine holds that its etiology is losses of spleen and kidney qi, qi and xue deficiency, in addition to secretion, genetic, anatomical, infection, systemic diseases, environmental factors and other related immune factors, the deficiency of blocking antibody is also one of the reasons for the lack of immune factors. In treating it, Chinese medicine treatment combines the patients personal constitution and treatment based on syndrome differentiation; Western medicine treatment mainly applies Aspirin, active immune lymphocyte treatment, low molecular heparin, gamma globulin protein passive immune treatment and psychological intervention therapy. In this paper, a review of the treatment methods for closed antibodies in the past 5 years is made.
基金National Natural Science Foundation of China(No.82102469)
文摘Objective:To analyze the proportion of peripheral regulatory T cells(Tregs)and the expression of the immune checkpoint molecules T-cell immunoglobulin and ITIM domain(TIGIT)and CD226 on Tregs in patients with recurrent spontaneous abortion(RSA).Methods:The proportion of CD3+CD4+CD25+Foxp3+Tregs and the expression levels of CD226 and TIGIT on Tregs in 30 normal pregnant women and 28 patients with RSA were determined via flow cytometry.Results:The proportion of Tregs in the RSA group(4.41%±1.54%)was significantly lower than that in the control group(5.27%±1.52%,P=0.0374).Compared with the normal pregnant women,patients with RSA showed decreased TIGIT expression(54.75±9.70%vs.63.07±12.48%,P=0.0066)and increased CD226 expression on Tregs(25.59%±8.22%vs.20.46%±6.97%,P=0.0168).The ratio of CD226 to TIGIT in the RSA group(0.48±0.19)was higher than that in the control group(0.34±0.15,P=0.0027).The proportion of TIGIT+CD226+Tregs was significantly lower in patients with RSA(9.30%±4.95%vs.13.43%±4.72%,P=0.0020)than in the controls.Conclusions:Patients with RSA show a reduced proportion of Tregs and an imbalance in the expression of TIGIT and CD226 on Tregs.
基金supported by the National Natural Science Foundation of China(Grant Nos.30730087,30530740,389073,39470722,39870666,39870775,30471822,and 30672231).
文摘Recurrent spontaneous abortion(RSA),defined as three or more consecutive pregnancy losses before 20 weeks of gestation,is difficult to treat in the clinical setting.It affects 1%–5%of women of reproductive age.In the investigations of immunopathogenesis,diagnosis,and treatment of RSA since the late 1980s,it was found that RSA was associated with abnormal maternal local or systemic immune response.The pathogenesis of autoimmune RSA was mainly associated with antiphospholipid antibody(APA),while that of alloimmune RSA was due to the disturbance of maternofetal immunological tolerance.Systemic etiological screening process and diagnosis systems of RSA with immune type were developed,and anticardiolipin(ACL or ACA)+anti-β2-GP1 antibody combining multiple assays for effective diagnosis of RSA with autoimmune type was first established.According to the dynamic monitoring of clinical parameters before and during gestation,low-dose,short-course,and individual immunosuppressive therapy and lymphocyte immunotherapy for RSA with immune type were carried out.The outcomes of the offsprings of patients with RSA were followed up,and the safety and validity of the therapies were confirmed.The research achievement leads to great progress in the diagnosis and treatment of RSA in China.
