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Wu L, Fang X, Lu F, Zhang Y, Wang Y, Kwak-Kim J. Anticardiolipin and/or anti-β2-glycoprotein-I antibodies are associated with adverse IVF outcomes. Front Immunol 2022; 13:986893. [PMID: 36405731 PMCID: PMC9667022 DOI: 10.3389/fimmu.2022.986893] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Accepted: 10/18/2022] [Indexed: 12/05/2022] Open
Abstract
OBJECTIVE The purpose of the study is to evaluate the effects of anticardiolipin (aCL) and/or anti-β2-glycoprotein-I (aβ2GPI) antibodies, namely antiphospholipid antibodies (aPL), on in vitro fertilization (IVF) outcomes. MATERIALS AND METHODS The study group comprised infertile women with aPL undergoing IVF-ET cycles. Controls were infertile women with tubal etiology without aPL. The impact of aPL on reproductive outcomes, such as oocyte quality, embryo quality, and implantation capacity, was compared between the study group and controls. Additionally, peripheral blood T cell subsets, such as T helper (Th)1, Th2, Th17, and T regulatory (Treg) cells and cytokines, were analyzed by the flow cytometry. Differences between the study group and controls were analyzed. RESULTS A total of 132 infertile women, including 44 women with aPL, and 88 controls were sequentially recruited for this study. Women with aPL had lower numbers of total and perfect/available embryos and lower rates of MII oocytes, blastocyst formation, perfect and available embryos, implantation, clinical pregnancy, and take-home baby. Additionally, imbalanced Th1/Th2 and Th17/Treg ratios, significantly higher levels of serum IL-2, TNF-α, IFN-γ, and IL-17A, and a significantly lower serum IL-4 were noticed in women with aPL compared to controls. CONCLUSION Women with aPL such as aCL and/or aβ2GPI antibodies were associated with adverse IVF outcomes. Early screening for aPL and appropriate consultation for couples undergoing IVF should be considered. In addition, underlying immunopathology and inflammatory immune mechanisms associated with aPL should be further explored.
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Affiliation(s)
- Li Wu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Xuhui Fang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Fangting Lu
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yu Zhang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Yanshi Wang
- Reproductive Medicine Center, Department of Obstetrics and Gynecology, The First Affiliated Hospital of University of Science and Technology of China (USTC), Division of Life Sciences and Medicine, University of Science and Technology of China, Hefei, Anhui, China
| | - Joanne Kwak-Kim
- Reproductive Medicine and Immunology, Obstetrics and Gynecology, Clinical Sciences Department, Chicago Medical School, Rosalind Franklin University of Medicine and Science, Vernon Hills, IL, United States,Center for Cancer Cell Biology, Immunology and Infection Diseases, Chicago Medical School, Rosalind Franklin University of Medicine and Science, North Chicago, IL, United States,*Correspondence: Joanne Kwak-Kim,
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Papadimitriou E, Boutzios G, Mathioudakis AG, Vlahos NF, Vlachoyiannopoulos P, Mastorakos G. Presence of antiphospholipid antibodies is associated with increased implantation failure following in vitro fertilization technique and embryo transfer: A systematic review and meta-analysis. PLoS One 2022; 17:e0260759. [PMID: 35895635 PMCID: PMC9328555 DOI: 10.1371/journal.pone.0260759] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Accepted: 11/16/2021] [Indexed: 11/27/2022] Open
Abstract
Purpose A systematic review and meta-analysis was conducted comparing the presence of anti-phospholipid (anti-PL) antibodies between women of reproductive age, without diagnosis of antiphospholipid syndrome, who experienced at least two implantation failures following in vitro fertilization and embryo transfer (IVF-ET), and either women who had a successful implantation after IVF-ET or women with at least one successful spontaneous pregnancy or unselected healthy fertile women with no history of IVF-ET. Methods Systematic search of the literature and meta-analysis of the relevant studies studying presence of antiphospholipid antibodies in women experiencing at least two implantation failures in IVF-ET as compared to either women who had a successful implantation after IVF-ET or/and women with at least one successful spontaneous pregnancy or unselected healthy fertile women with no history of IVF-ET. Six hundred ninety-four published reports were retrieved; 17 of them fulfilled the inclusion criteria set. Results Presence of either any type of anti-phospholipid or anticardiolipin antibodies or lupus-anticoagulant in women experiencing at least two implantation failures in IVF-ET was associated with increased implantation failure compared to women who had a successful implantation after IVF-ET (relative risk, RR: 3.06, 5.06 and 5.81, respectively). Presence of either anticardiolipin or lupus-anticoagulant or anti-beta2 glycoprotein-I or anti-phosphatidylserine antibodies in women experiencing at least two implantation failures in IVF-EΤ was associated with increased implantation failure compared to unselected healthy fertile women with no history of IVF-ET (RR:13.92, 6.37, 15.04 and 164.58, respectively). Conclusion The prevalence of antiphospholipid antibodies, particularly that of anti-beta2 glycoprotein-I and anti-phosphatidylserine antibodies, in women experiencing at least two implantation failures in IVF-ET without diagnosis of antiphospholipid syndrome is significantly greater than either in women who had a successful implantation after IVF-ET or women with at least one successful spontaneous pregnancy or unselected healthy fertile women with no history of IVF-ET. Trial registration number PROSPERO ID: CRD42018081458
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Affiliation(s)
- Eirini Papadimitriou
- Department of Pathophysiology, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- Endocrine Unit, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Georgios Boutzios
- Department of Pathophysiology, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Alexander G. Mathioudakis
- Division of Infection, Immunity and Respiratory Medicine, School of Biomedical Sciences, The University of Manchester, Manchester, United Kingdom
- North West Lung Centre, Wythenshawe Hospital, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom
| | - Nikos F. Vlahos
- 2 Department of Obstetrics and Gynecology, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Panayiotis Vlachoyiannopoulos
- Department of Pathophysiology, Laiko University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - George Mastorakos
- Endocrine Unit, Aretaieion University Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
- * E-mail:
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Liu J, Zhang L, Tian Y, Wan S, Hu M, Song S, Zhang M, Zhou Q, Xia Y, Wang X. Protection by hydroxychloroquine prevents placental injury in obstetric antiphospholipid syndrome. J Cell Mol Med 2022; 26:4357-4370. [PMID: 35770338 PMCID: PMC9344817 DOI: 10.1111/jcmm.17459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 06/06/2022] [Accepted: 06/10/2022] [Indexed: 12/15/2022] Open
Abstract
Obstetric antiphospholipid syndrome (OAPS) is mediated by antiphospholipid antibodies (aPLs, and anti‐β2 glycoprotein I antibody is the main pathogenic antibody), and recurrent abortion, preeclampsia, foetal growth restriction and other placental diseases are the main clinical characteristics of placental pathological pregnancy. It is a disease that seriously threatens the health of pregnant women. Hydroxychloroquine (HCQ) was originally used as an anti‐malaria drug and has now shown benefit in refractory OAPS where conventional treatment has failed, with the expectation of providing protective clinical benefits for both the mother and foetus. However, its efficacy and mechanism of action are still unclear. After clinical data were collected to determine the therapeutic effect, human trophoblast cells in early pregnancy were prepared and treated with aPL. After the addition of HCQ, the proliferation, invasion, migration and tubule formation of the trophoblast cells were observed so that the therapeutic mechanism of HCQ on trophoblast cells could be determined. By establishing an obstetric APS mouse model similar to the clinical situation, we were able to detect the therapeutic effect of HCQ on pathological pregnancy. The normal function of trophoblast cells is affected by aPL. Antibodies reduce the ability of trophoblast cells to invade and migrate and can impair tubule formation, which are closely related to placental insufficiency. HCQ can partially reverse these side effects. In the OAPS mouse model, we found that HCQ prevented foetal death and reduced the incidence of pathological pregnancy. Therefore, HCQ can improve pregnancy outcomes and reverse the aPL inhibition of trophoblast disease. In OAPS, the use of HCQ needs to be seriously considered.
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Affiliation(s)
- Jing Liu
- Department of Obstetrics and Gynaecology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Liting Zhang
- Department of Obstetrics and Gynaecology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yijia Tian
- Department of Obstetrics and Gynaecology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Shuting Wan
- Department of Obstetrics and Gynaecology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Min Hu
- Department of Obstetrics and Gynaecology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Shasha Song
- Maternal and Child Health Care Hospital of Shandong Province, Jinan, China
| | - Meihua Zhang
- The Laboratory of Placenta-Related Diseases, Key Laboratory of Birth Regulation and Control Technology of National Health and Family Planning Commission of China, Jinan, China
| | - Qian Zhou
- Department of Obstetrics and Gynaecology, Shandong Provincial Hospital, Shandong University, Jinan, China
| | - Yu Xia
- Central Laboratory, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, China
| | - Xietong Wang
- Department of Obstetrics and Gynaecology, Shandong Provincial Hospital, Shandong University, Jinan, China.,Maternal and Child Health Care Hospital of Shandong Province, Jinan, China.,The Laboratory of Placenta-Related Diseases, Key Laboratory of Birth Regulation and Control Technology of National Health and Family Planning Commission of China, Jinan, China
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Jarne-Borràs M, Miró-Mur F, Anunciación-Llunell A, Alijotas-Reig J. Antiphospholipid antibodies in women with recurrent embryo implantation failure: A systematic review and meta-analysis. Clin Exp Rheumatol 2022; 21:103101. [PMID: 35452853 DOI: 10.1016/j.autrev.2022.103101] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2022] [Accepted: 04/18/2022] [Indexed: 01/07/2023]
Abstract
OBJECTIVE Antiphospholipid antibodies (aPL) are related to poor pregnancy outcomes, but their effect on embryo implantation is unclear. We aimed to assess the prevalence of different aPL in women with recurrent implantation failure (RIF). METHODS We searched studies in PubMed (MEDLINE), Scopus and Cochrane Library. Quality of studies was scored by the Newcastle-Ottawa Scale and risk of bias assessment by items described in RevMan5 software. Statistical analyses were made using random-effects model and presented as pooled Odds Ratio (OR), 95% confidence interval (CI). Heterogeneity was assessed by I2% and D2%. RESULTS This systematic review and meta-analysis included 17 studies and showed a high degree of variability in aPL positivity in RIF. In the latter, the risk of bias assessment suggested unclear bias on study performance with a median sample size and interquartile range for RIF patients and fertile women of 96 (57-417) and 100 (60.5-202.5), respectively. Among the criteria aPL, IgG anticardiolipin autoantibodies (OR 5.02, 95% CI [1.95, 12.93]) were associated with RIF. Within the non-criteria aPL, anti-β2 glycoprotein I-IgA (OR 64.8, 95% CI [9.74, 431.0]), and antiphosphatidylglycerol-IgG and IgM (OR 10.74, 95% CI [5.25, 22.0]; OR 4.26, 95% CI [1.76,10.31]; respectively) were associated with RIF, too. CONCLUSIONS Anticardiolipin-IgG is a prevalent autoantibody in women with RIF. Three other non-criteria aPL, aβ2GP I-IgA, aPG-IgG and aPG-IgM also present a positive rate in RIF. Overall, these results advise about testing them as indicators of RIF risk in women seeking IVF treatment.
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Affiliation(s)
| | - Francesc Miró-Mur
- Systemic Autoimmune Research Unit, Vall d'Hebron Institut de Recerca, Barcelona, Spain.
| | | | - Jaume Alijotas-Reig
- Systemic Autoimmune Research Unit, Vall d'Hebron Institut de Recerca, Barcelona, Spain; Systemic Autoimmune Diseases Unit, Department of Internal Medicine, Vall d'Hebron University Hospital, Barcelona, Spain; Department of Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain.
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Li J, Gao Y, Guan L, Zhang H, Chen P, Gong X, Li D, Liang X, Huang M, Bi H. Lipid Profiling of Peri-implantation Endometrium in Patients With Premature Progesterone Rise in the Late Follicular Phase. J Clin Endocrinol Metab 2019; 104:5555-5565. [PMID: 31390011 DOI: 10.1210/jc.2019-00793] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2019] [Accepted: 08/01/2019] [Indexed: 12/14/2022]
Abstract
CONTEXT Late follicular phase elevation in serum progesterone (P) during controlled ovarian hyperstimulation negatively affects the outcome of assisted reproductive technology by contributing to endometrial-embryo asynchrony. There are still no data on lipid metabolite alterations during this process. OBJECTIVES To investigate alterations in the lipid profile during the window of implantation in patients with premature P rise. DESIGN Lipidomic variations in the endometrium were evaluated by ultrahigh-performance liquid chromatography coupled with electrospray ionization high-resolution mass spectrometry. SETTING University assisted reproductive medicine unit. PATIENTS OR OTHER PARTICIPANTS Forty-three patients undergoing in vitro fertilization/intracytoplasmic sperm injection because of a tubal factor or male factor infertility were included in this study. The patients were divided into a high P group (P ≥ 1.5 ng/mL, 15 patients) and a normal P group (P < 1.5 ng/mL, 28 patients) on the day of human chorionic gonadotropin administration. INTERVENTIONS The endometrial tissues were obtained by Pipelle biopsy 7 days after human chorionic gonadotropin administration. MAIN OUTCOME MEASURES Alterations in lipid metabolites. RESULTS A total of 1026 ions were identified, and 25 lipids were significantly upregulated. The endometrial lipid profile was characterized by substantial increases in the concentrations of phosphatidylcholine, phosphatidylethanolamine, lysophosphatidylcholine, diacylglycerol, ceramide, phosphatidylinositol, and phosphatidylserine in patients with a premature P rise at the end of the follicular phase. The correlation analysis between P levels and lipids showed a stronger negative correlation between phosphatidylethanolamine or phosphatidylserine and P levels. CONCLUSIONS Premature P elevation disrupts the lipid homeostasis of the endometrium during the peri-implantation period. The altered lipid levels may impair endometrial receptivity and early embryo implantation.
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Affiliation(s)
- Jingjie Li
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China
| | - Yue Gao
- Center of Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Lihuan Guan
- Center of Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huizhen Zhang
- Center of Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Pan Chen
- Department of Pharmacy, the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiao Gong
- School of Public Health, Guangdong Pharmaceutical University, Guangzhou, China
| | - Dongshun Li
- Center of Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Xiaoyan Liang
- School of Pharmaceutical Sciences, Sun Yat-sen University, Guangzhou, China
| | - Min Huang
- Center of Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
| | - Huichang Bi
- Center of Reproductive Medicine, the Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, China
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Yang W, Wu Z, Yu M, Peng X, Lu W, Feng W, Kang X. Characteristics of midluteal phase uterine artery hemodynamics in patients with recurrent pregnancy loss. J Obstet Gynaecol Res 2019; 45:1230-1235. [PMID: 30977230 DOI: 10.1111/jog.13944] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2018] [Accepted: 02/02/2019] [Indexed: 11/30/2022]
Abstract
AIM To study the association in resistance to uterine artery blood flow and recurrent pregnancy loss (RPL) and find its potential influencing factors. METHODS A retrospective study was conducted in 870 RPL and 237 non-RPL patients visiting to the Clinic from January 2014 to February 2018. All participants underwent comprehensive examinations and were scanned by transvaginal Doppler ultrasonography during the midluteal phase to measure the pulsatility index (PI), resistance index (RI) and systolic/diastolic ratio (S/D) values of the left and right main uterine arteries. P value less than 0.05 was considered statistically significant. RESULTS The mean PI, RI and S/D values for uterine arteries were significantly higher in RPL patients than in non-RPL patients (P < 0.001). When subjects were grouped according to the different etiologies of RPL, significant higher indices of uterine arteries were found in RPL patients with antiphospholipid syndrome (P < 0.001), autoimmune diseases (P < 0.001), endocrinological abnormalities (P < 0.05), thrombophilia (P < 0.001), uterine anomalies (P < 0.01) and unexplained RPL (P < 0.001). No differences were found between patients with chromosomal anomalies and uterine arteries blood flow (P > 0.05). In RPL patients, mean PI, mean RI and mean S/D values shows no difference among groups (P > 0.05). The Similar results were observed in age and number of spontaneous abortion (P > 0.05). CONCLUSION Impaired uterine artery blood perfusion may be an underlying pathology to RPL, and it can be used as an independent risk factor for pregnancy failure.
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Affiliation(s)
- Wen Yang
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Ze Wu
- Department of Reproductive Medical Center, The First People's Hospital of Yunnan Province, Kunming, China
| | - Ming Yu
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Xuenan Peng
- School of Medicine, Suzhou University, Suzhou, China
| | - Wei Lu
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Wen Feng
- Department of Gynecology, The People's Hospital of Lianyungang, Lianyungang, China
| | - Xiaomin Kang
- Department of Reproductive Medical Center, The First People's Hospital of Yunnan Province, Kunming, China
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Triggianese P, Watad A, Cedola F, Perricone C, Amital H, Giambini I, Perricone R, Shoenfeld Y, De Carolis C. Vitamin D deficiency in an Italian cohort of infertile women. Am J Reprod Immunol 2017; 78. [DOI: 10.1111/aji.12733] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2017] [Accepted: 07/11/2017] [Indexed: 12/21/2022] Open
Affiliation(s)
- Paola Triggianese
- Rheumatology, Allergology and Clinical Immunology; Department of “Medicina dei Sistemi”; University of Rome Tor Vergata; Rome Italy
| | - Abdulla Watad
- Department of Medicine ‘B’; Tel-Aviv University; Tel-Aviv Israel
- Zabludowicz center for Autoimmune Diseases; Tel-Aviv University; Tel-Aviv Israel
- Sackler Faculty of Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Francesca Cedola
- Rheumatology, Allergology and Clinical Immunology; Department of “Medicina dei Sistemi”; University of Rome Tor Vergata; Rome Italy
| | - Carlo Perricone
- Reumatologia, Dipartimento di Medicina Interna e Specialità Mediche; Sapienza Università di Roma; Rome Italy
| | - Howard Amital
- Department of Medicine ‘B’; Tel-Aviv University; Tel-Aviv Israel
- Zabludowicz center for Autoimmune Diseases; Tel-Aviv University; Tel-Aviv Israel
- Sackler Faculty of Medicine; Tel-Aviv University; Tel-Aviv Israel
| | - Ilio Giambini
- Department of Laboratory Medicine; Tor Vergata University Hospital of Rome; Rome Italy
| | - Roberto Perricone
- Rheumatology, Allergology and Clinical Immunology; Department of “Medicina dei Sistemi”; University of Rome Tor Vergata; Rome Italy
| | - Yehuda Shoenfeld
- Department of Medicine ‘B’; Tel-Aviv University; Tel-Aviv Israel
- Zabludowicz center for Autoimmune Diseases; Tel-Aviv University; Tel-Aviv Israel
| | - Caterina De Carolis
- Polymedical Center for Prevention of Recurrent Spontaneous Abortion; Rome Italy
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Kwak-Kim J, Skariah A, Wu L, Salazar D, Sung N, Ota K. Humoral and cellular autoimmunity in women with recurrent pregnancy losses and repeated implantation failures: A possible role of vitamin D. Autoimmun Rev 2016; 15:943-7. [DOI: 10.1016/j.autrev.2016.07.015] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2016] [Accepted: 07/06/2016] [Indexed: 11/16/2022]
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Abstract
Some cases of reproductive failure with autoimmune background are characterized by the involvement of autoantibodies. This occurs mainly in patients having systemic lupus erythematosus or antiphospholipid syndrome. The autoantibodies associated with reproductive failure include: a) antibodies which directly bind phospholipid (e.g., cardiolipin, phosphatidylserine, phosphatidylethanolamine); b) antiphospholipid Abs which bind the phospholipid via phospholipid-binding glycoproteins such as b2glycoprotein-I, annexin V and prothrombin; c) autoantibodies directed to laminin-I, actin, thromboplastin, the corpus luteum, prolactin, poly (ADP-ribose), thyroglobulin and mitochondrial antibodies of the M5 type. This paper will focus on the association of antiphosphatidylserine autoantibodies and reproductive failure. Future studies are likely to help to identify peptides resembling the epitope specificities associated with the specific clinical manifestations.
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Affiliation(s)
- M Blank
- Internal Medicine B and The Center for Autoimmune Diseases, Sheba Medical Center, Tel-Hashomer, Sackler Faculty of Medicine, Tel-Aviv University, Israel
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10
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Heng BC, Huang W, Zhong X, Yin P, Tong GQ. Roles of Antiphospholipid Antibodies, Antithyroid Antibodies and Antisperm Antibodies in Female Reproductive Health. ACTA ACUST UNITED AC 2015. [DOI: 10.1159/000381900] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
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11
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Petrušić V, Todorović N, Živković I, Dimitrijević R, Muhandes L, Rajnpreht I, Dimitrijević L. Autoantibody response and pregnancy-related pathology induced by combined LPS and tetanus toxoid hyperimmunization in BALB/c and C57BL/6 mice. Autoimmunity 2014; 48:87-99. [DOI: 10.3109/08916934.2014.961061] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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12
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Carp HJ, Selmi C, Shoenfeld Y. The autoimmune bases of infertility and pregnancy loss. J Autoimmun 2012; 38:J266-74. [PMID: 22284905 DOI: 10.1016/j.jaut.2011.11.016] [Citation(s) in RCA: 146] [Impact Index Per Article: 12.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2011] [Revised: 11/28/2011] [Accepted: 11/28/2011] [Indexed: 11/26/2022]
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13
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Check JH. The Use of Heparin for Preventing Miscarriage. Am J Reprod Immunol 2012; 67:326-33. [DOI: 10.1111/j.1600-0897.2012.01119.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2012] [Accepted: 02/02/2012] [Indexed: 12/23/2022] Open
Affiliation(s)
- Jerome H. Check
- Division of Reproductive Endocrinology & Infertility, Department of Obstetrics and Gynecology; University of Medicine and Dentistry of New Jersey, Robert Wood Johnson Medical School at Camden, Cooper Hospital/University Medical Center; Camden; NJ; USA
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Zivkovic I, Stojanovic M, Petrusic V, Inic-Kanada A, Dimitrijevic L. Induction of APS after TTd hyper-immunization has a different outcome in BALB/c and C57BL/6 mice. Am J Reprod Immunol 2010; 65:492-502. [PMID: 21029246 DOI: 10.1111/j.1600-0897.2010.00922.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
Abstract
PROBLEM The antiphospholipid syndrome (APS) is a systemic autoimmune disease characterized by vascular thrombosis and/or pregnancy complications (lower fecundity and lower litter size), as well as by an increase in anti-β(2) glycoprotein I (β(2) GPI)-specific autoantibody titer. We have investigated how the genetic background of the immune system [T helper (Th) prevalence] and the type of animal model of APS influence the induced pathology. METHOD OF STUDY Antiphospholipid syndrome induced by tetanus toxoid (TTd) hyper-immunization and by intravenous application of monoclonal anti-β(2) GPI-specific antibody 26 was compared in C57BL/6 (Th1 prone) and BALB/c (Th2 prone) mice. RESULTS Tetanus toxoid hyper-immunization of BALB/c mice led to reduction in fertility, but in C57BL/6 mice a decrease in fecundity occurred. In both cases, pathology was caused by anti-β(2) GPI antibodies, the production of which was adjuvant and strain dependent. CONCLUSION We conclude that TTd immunization and i.v. application of monoclonal antibody 26 induced the same reproductive pathology and that the type of pathology is strain dependent.
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Affiliation(s)
- Irena Zivkovic
- Institute of Virology, Vaccines and Sera - Torlak, Belgrade, Serbia.
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15
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Antiphospholipid antibody-mediated reproductive failure in antiphospholipid syndrome. Clin Rev Allergy Immunol 2010; 38:141-7. [PMID: 19562524 DOI: 10.1007/s12016-009-8146-x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
The association of elevated titers of circulating antiphospholipid (anti-PL) Abs in antiphospholipid syndrome (APS) and reproductive failure is well established in the literature. The clinical features include recurrent abortions at various stages, including implantation, placentation in the first trimester, miscarriages in the second and third trimesters, intrauterine growth retardation, preeclampsia with placental insufficiency and growth restrictions, arterial and venous thrombosis, and possibly also infertility. APS-mediated recurrent pregnancy loss and other features of reproductive failure might result from diverse autoimmune factors, inflammation, involving different mechanisms, which encompass pathogenic anti-PL Abs. Herein, we discuss the association of anti-PL Abs with reproductive failure with special emphasis on antiphospholipid autoantibodies characterizing APS. This association is evident from either human studies or murine models.
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Abstract
Defective reaction toward fetal alloantigens could result in both recurrent spontaneous abortions (RSAs) and recurrent early pregnancy failures (REPFs), the latter existing in couples with unexplained infertility and multiple failures of implantation after in vitro fertilization embryo transfer. Immunological mechanisms leading to RSA and REPF seem to be different, although both syndromes probably have a genetic background that has not been identified so far. Despite the fact that antiphospholipid syndrome is a well-established cause of repeated pregnancy loss, the role of different autoantibodies existing in RSA and REPF patients needs to be elucidated. Immunotherapy is believed to correct the detrimental immune reactions; however, its real effectiveness and safety for the treatment of distinct forms of pregnancy loss need to be reconsidered.
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Affiliation(s)
- Jacek R Wilczynski
- Polish Mother's Health Center Research Institute, Department of Gynecological Surgery, 281/289 Rzgowska Street, 93-338 Lódz, Poland.
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17
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Buckingham K, Chamley L. A critical assessment of the role of antiphospholipid antibodies in infertility. J Reprod Immunol 2009; 80:132-45. [DOI: 10.1016/j.jri.2008.11.005] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2008] [Accepted: 11/07/2008] [Indexed: 10/21/2022]
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18
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Králícková M, Ulcová-Gallová Z, Síma R, Vanecek T, Síma P, Krizan J, Suchá R, Uher P, Hes O, Novotný Z, Rokyta Z, Vetvicka V. Association of the leukemia inhibitory factor gene mutation and the antiphospholipid antibodies in the peripheral blood of infertile women. Folia Microbiol (Praha) 2008; 52:543-8. [PMID: 18298054 DOI: 10.1007/bf02932117] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
To characterize the impact of the potentially functional mutation--the G to A transition at the position 3400 of the leukemia inhibitory factor (LIF; a pluripotent cytokine that plays a central role in the control of the embryo implantation) gene that leads to the exchange of valine with methionine at codon 64 we evaluated the association of the LIF gene mutation and the levels of antiphospolipid antibodies (aPLs) in the peripheral blood of infertile women (the aPLs examination was part of our routine immunological test during the infertility check-up). Eight infertile mutation-positive women were diagnosed with idiopathic infertility (n=5) and endometriosis (n=3) and their levels of aPLs in serum were compared with 115 infertile women without any LIF gene mutation. Enzyme-linked immunosorbent assay was used for the detection of seven antiphospholipid antibodies; the results were statistically assessed by the Fisher's 2 by 2 exact test to evaluate the association of the LIF gene mutations and aPLs in serum of infertile patients. The presence of aPLs was significantly higher in our study group (100%) than in 30% of aPLs-positives in control infertile patients (p = 0.0035) which indicates that the aPLs are elevated in women with LIF gene mutations.
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Affiliation(s)
- M Králícková
- Department of Obstetrics and Gynecology, University Hospital, Faculty of Medicine, Charles University, 301 66 Plzei, Czechia.
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19
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Anti-Phospholipid Antibodies And Infertility. Clin Rev Allergy Immunol 2007; 32:159-61. [DOI: 10.1007/s12016-007-0010-2] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/1999] [Revised: 11/30/1999] [Accepted: 11/30/1999] [Indexed: 10/23/2022]
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20
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Midluteal phase Doppler assessment of uterine artery blood flow in nonpregnant women having a history of recurrent spontaneous abortions: correlation to different etiologies. Fertil Steril 2007; 87:1383-7. [DOI: 10.1016/j.fertnstert.2006.11.049] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2006] [Revised: 11/14/2006] [Accepted: 11/14/2006] [Indexed: 11/17/2022]
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21
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Lee SR, Park EJ, Kim SH, Chae H, Kim CH, Kang BM. Influence of antiphospholipid antibodies on pregnancy outcome in women undergoing in vitro fertilization and embryo transfer. Am J Reprod Immunol 2007; 57:34-9. [PMID: 17156189 DOI: 10.1111/j.1600-0897.2006.00437.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
PROBLEM Antiphospholipid antibodies (APA) are thought to be involved in recurrent pregnancy loss. Therefore, we investigated the impact of APA on pregnancy outcome in women undergoing in vitro fertilization and embryo transfer (IVF-ET). METHOD OF STUDY Blood samples taken from 54 Korean women referred for IVF were tested for the presence of APA, anticardiolipin antibody IgG and IgM and lupus anticoagulant. The standard gonadotropin-releasing hormone agonist long protocol was used for ovarian stimulation. RESULTS Nine patients (16.7%) were positive and 45 (83.3%) were negative for APA. There were no significant differences between the two groups in clinical characteristics such as age, infertility duration, and response to controlled ovarian hyperstimulation. However, pregnancy outcome significantly differed between the two groups (p < 0.05). The APA positive group and APA negative group had abortion rates of 62.5% and 20.0%, respectively and delivery rates of 37.5% and 80.0%, respectively. CONCLUSION The presence of APA in women undergoing IVF-ET was associated with a poor pregnancy outcome.
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Affiliation(s)
- Sa-Ra Lee
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
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22
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Matsubayashi H, Sugi T, Arai T, Shida M, Kondo A, Suzuki T, Izumi SI, McIntyre JA. IgG-antiphospholipid antibodies in follicular fluid of IVF-ET patients are related to low fertilization rate of their oocytes. ACTA ACUST UNITED AC 2006; 55:341-8. [PMID: 16635208 DOI: 10.1111/j.1600-0897.2006.00374.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
PROBLEM Patients undergoing in vitro fertilization and embryo transfer (IVF-ET) failures show an increased incidence of antiphospholipid antibodies (aPL) in their blood. The physiological manifestations of aPL in this patient group are nonetheless controversial. Pathological effects of aPL on embryos in vitro have been documented. We questioned whether aPL if found in follicular fluids (FFs) could result in embryonic damage. METHOD OF STUDY Blood from 44 patients with three or more IVF-ET failures were tested by enzyme-linked immunosorbent assays (ELISA) for the presence of immunoglobulin (Ig)G, IgM and IgA aPL. Both the 29 aPL-positive and 15 aPL-negative patients gave permission for FF collection during their next IVF-ET attempt for additional aPL determinations. RESULTS Patients with no aPL in their blood, had no aPL in their FFs. Patients with IgG and/or IgM aPL in their blood had IgG but not IgM in their respective FFs. CONCLUSIONS The presence of IgG aPL in FFs and increased infertility length were significantly related to lower fertilization rates, independently. Follicular fluid IgG aPL appears as a risk factor in association with successful IVF-ET outcomes.
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Affiliation(s)
- Hidehiko Matsubayashi
- Department of Obstetrics and Gynecology, Specialized Clinical Science, Tokai University School of Medicine, Kanagawa, Japan.
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23
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Fernández-Llanio N, Alegre-Sancho JJ, Chalmeta-Verdejo C, Fernández-Carballido C, Román-Ivorra JA. [Hormone therapy, fertility and pregnancy in antiphospholipid syndrome]. REUMATOLOGIA CLINICA 2006; 2:90-106. [PMID: 21794309 DOI: 10.1016/s1699-258x(06)73027-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2005] [Accepted: 09/05/2005] [Indexed: 05/31/2023]
Abstract
Antiphospholipid syndrome (APS) carries a risk of thrombosis and infertility. Consequently the use of any type of hormone therapy and pregnancy in APS requires special considerations. The present article provides a broad review of all these issues. The use of contraception, hormone replacement therapy and selective estrogen receptor modulators in APS are described. In vitro fertilization/embryo transfer and ovarian induction in these patients are reviewed. Lastly, the possible fetal and maternal complications that can occur during pregnancy are described and, based on the literature, recommendations for the management of pregnancy in women with APS are provided.
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Affiliation(s)
- N Fernández-Llanio
- Sección de Reumatología. Hospital Universitario Dr. Peset. Valencia. España
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Vaquero E, Lazzarin N, Caserta D, Valensise H, Baldi M, Moscarini M, Arduini D. Diagnostic evaluation of women experiencing repeated in vitro fertilization failure. Eur J Obstet Gynecol Reprod Biol 2006; 125:79-84. [PMID: 16223559 DOI: 10.1016/j.ejogrb.2005.08.001] [Citation(s) in RCA: 52] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2004] [Revised: 07/30/2005] [Accepted: 08/02/2005] [Indexed: 11/27/2022]
Abstract
OBJECTIVE The aim of the study was to propose a set of tests to clarify the diagnosis of repeated implantation failure in patients undergoing in vitro fertilization (IVF). STUDY DESIGN Fifty-nine patients with at least two unsuccessful IVF attempts were included in the study. Blood samples were evaluated for the presence of underlying thyroid abnormalities, antiphospholipid antibodies (aPL), increased levels of natural killer cells (NK), inherited thrombophilia and mouse embryo assay factor (MEA-f). The same tests were performed on 20 normal fertile control patients. RESULTS Seventy-six percent of IVF patients showed at least one abnormal result. This incidence was higher with respect to that found among control patients (45%). The prevalence of thyroid abnormalities, aPL and increased NK level was higher in IVF patients whereas no differences were observed in terms of prevalence of inherited thrombophilias and MEA-f. CONCLUSIONS A better understanding of reproductive failure mechanisms should allow an effective diagnostic flow chart and a focused therapeutic option for patients experiencing repeated IVF failure. With this objective in mind, our data provide two important results: thyroid abnormalities, aPL and increased NK levels are more prevalent in women experiencing IVF failure. No evidence was found for an association between inherited thrombophilia and MEA-f and failure to achieve pregnancy after IVF.
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Affiliation(s)
- Elena Vaquero
- Department of Obstetrics and Gynecology, Ospedale Fatebenefratelli, University of Rome Tor Vergata, Isola Tiberina, 00168 Rome, Italy.
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25
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McIntyre JA, Wagenknecht DR, Faulk WP. Redox-reactive autoantibodies: Detection and physiological relevance. Autoimmun Rev 2006; 5:76-83. [PMID: 16338215 DOI: 10.1016/j.autrev.2005.07.009] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2005] [Accepted: 07/28/2005] [Indexed: 11/29/2022]
Abstract
We recently described a hitherto unrecognized family of autoantibodies that become unmasked (detectable) subsequent to oxidation-reduction (redox) reactions. These masked redox-reactive autoantibodies are not detectable by using conventional immunoassays. Additional experimentation has demonstrated that autoantibodies in the blood of patients with autoimmune diseases can be masked (become undetectable) by exposure to oxidizing agents. Simultaneous masking and unmasking of different autoantibodies in a given patient's serum or plasma is evidence that immune complexes are not the source of redox-reactive autoantibodies. We propose that a mechanism responsible for unmasking-masking antibody specificities requires nitrosylation of tyrosine residues in the hypervariable or complementarity determining regions of the antibodies' antigen-binding sites. Other laboratories, selected by us for their respective expertise, have studied our redox-reacted and control serum and/or antibody preparations and have found an expanding array of autoantibody specificities. The gathering data suggest that certain autoimmune diseases may involve redox disorders rather than a failure to deplete, suppress, tolerate or divert self-directed B cell activity. The persistence and fluctuation of redox-reactive autoantibodies suggest that they are manifestations of an as yet undefined natural selective pressure on the evolution of the immunological system. We propose that they are the "contrivances" suggested by Paul Ehrlich more than a hundred years ago, and that these antibodies perform important physiological and pathophysiological functions.
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Affiliation(s)
- John A McIntyre
- HLA-Vascular Biology Laboratory, St Francis Hospital and Health Care Centers, 1600 Albany Street, Beech Grove, IN 46107, USA.
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26
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Xu Y, Knipp GT, Cook TJ. Effects of di-(2-ethylhexyl)-phthalate and its metabolites on the lipid profiling in rat HRP-1 trophoblast cells. Arch Toxicol 2005; 80:293-8. [PMID: 16328440 DOI: 10.1007/s00204-005-0047-z] [Citation(s) in RCA: 33] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2005] [Accepted: 10/26/2005] [Indexed: 10/25/2022]
Abstract
The highly directional maternal-to-fetal transfer of essential fatty acids (EFAs) across the placenta plays a critical role in guiding proper fetal development. Exposure to xenobiotics that may alter the fetal supply of EFAs/lipids could lead to fetal toxicity. Since the placenta is the first fetal arising organ that regulates fetal fatty acid homeostasis, the fatty acid/lipid composition in the placenta may serve as an indicator of fetal composition. In this study, we investigated the effects of the peroxisome proliferator chemical di-(2-ethylhexyl)-phthalate (DEHP), a widely used plasticizer and ubiquitous environmental contaminant, and its selective metabolites, mono-(2-ethylhexyl)-phthalate (MEHP) and 2-ethylhexanoic acid (EHA) on the lipid metabolome in a rat HRP-1 trophoblast model. The concentrations of ten lipid classes (cholesterol esters, diacylglycerol, triacylglycerides, phosphatidylcholine, phosphatidylethanolamine, phosphatidylserine, lysophosphatidylcholine, cardiolipin, and sphingomyelin) were determined, as well as the individual fatty acid compositions, especially the omega-3 and omega-6 family of EFAs. The level of each lipid class was significantly increased upon exposure to the agents, with MEHP and EHA generally showing higher increases than DEHP. The same trends were observed in comparing the fatty acid compositions. For example, the omega-3/omega-6 fatty acids ratio did not change, although the levels of omega-3 and omega-6 fatty acids were significantly elevated upon exposure. These results suggest that DEHP and its metabolites can alter lipid metabolome in a rat placental cell line, implying that these compounds may contribute to aberrant placental EFA/lipid homeostasis caused by peroxisome proliferation, and potentially result in abnormal fetal development.
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Affiliation(s)
- Yan Xu
- Department of Pharmaceutics, Ernest Mario School of Pharmacy and the Environmental & Occupational Health Sciences Institute, Rutgers, The State University of New Jersey, 160 Frelinghuysen Road, Piscataway, NJ 08854, USA
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27
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McIntyre JA, Wagenknecht DR, Faulk WP. Autoantibodies unmasked by redox reactions. J Autoimmun 2005; 24:311-7. [PMID: 15927793 DOI: 10.1016/j.jaut.2005.03.005] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2005] [Revised: 03/11/2005] [Accepted: 03/15/2005] [Indexed: 10/25/2022]
Abstract
Blood from healthy donors was found to contain a variety of autoantibodies after being cultured overnight in commercial blood culture bottles. Paradoxically some autoantibodies in the blood of patients with autoimmune diseases were no longer detectable when similarly cultured. By a process of elimination it was revealed that hemin was responsible for the conversion of antibody-negative blood to antibody-positive blood, as well as for the conversion of antibody-positive blood to antibody-negative blood. By using a purified component system of hemin and immunoglobulin, and an iron-free congener of hemin, we have shown that the appearance and/or disappearance of antibodies occur uniquely in the presence of coordinated iron and in the absence of antioxidants such as vitamin C. The oxidation-reduction (redox) reactions used to demonstrate the appearance and disappearance of autoantibodies have been performed in vitro. Whether the reactions we have observed have a parallel in vivo remains to be determined. It is clear from our findings that normal individuals have immunoglobulin molecules which can exhibit autoantibody binding capacity, and that at least some autoantibodies in autoimmune individuals can have their binding capacity masked by exercise of a natural redox system. These preliminary findings need further investigation but they already hint that some of our apparently well based views on autoimmunity might be expanded to include a role for masked and unmasked autoantibodies.
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Affiliation(s)
- John A McIntyre
- HLA-Vascular Biology Laboratory, St. Francis Hospital and Health Centers, 1500 Albany Street, Beech Grove, IN 46107, USA.
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28
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Matsubayashi H, Shida M, Kondo A, Suzuki T, Sugi T, Izumi SI, Hosaka T, Makino T. Preconception Peripheral Natural Killer Cell Activity as a Predictor of Pregnancy Outcome in Patients with Unexplained Infertility. Am J Reprod Immunol 2005; 53:126-31. [PMID: 15727566 DOI: 10.1111/j.1600-0897.2005.00255.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
PROBLEM Preconception high peripheral natural killer (NK) cell activity in women with recurrent spontaneous abortion can predict subsequent miscarriages. We have examined prospectively, for the first time, the pregnancy rate in patients with unexplained infertility by measuring the peripheral NK activity. METHOD OF STUDY We tested the peripheral NK activity of 94 infertile women who despite treatment were unable to conceive for 6 or more months (mean; 2.4 years). Peripheral NK activity was measured by a chromium-51 release cytotoxicity assay. Women were followed for 2 years and assessed. RESULTS In 77 patients who were followed for 2 years, 28 had conceived but 49 did not. The peripheral NK activity of the group that became pregnant (mean +/- S.D.; 34.5 +/- 13.8%) was significantly lower than that of non-conception group (42.3 +/- 13.3%, P = 0.017). CONCLUSIONS Our finding suggests that elevated peripheral NK activity in patients with unexplained infertility is a risk factor for attaining pregnancy success.
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Affiliation(s)
- Hidehiko Matsubayashi
- Department of Obstetrics and Gynecology, Tokai University School of Medicine, Kanagawa, Japan.
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29
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Abstract
The juxtaposition of the maternal and fetal circulations allows optimal physiological exchange between mother and fetus. Extravillous trophoblast infiltrating into the placental bed transforms the small calibre spiral arteries into large calibre uteroplacental arteries. The absence of these physiological changes, coupled with other lesions such as acute atherosis, results in a reduced uteroplacental blood flow, as seen in pre-eclampsia, intrauterine growth restriction and preterm delivery. A failure to elaborate the placental vascular tree can result in impaired flow through the fetal placental circulation. Placental vascular malformations, such as placental mesenchymal dysplasia and the commoner chorangioma, can lead to neonatal complications. Fetal thrombotic vasculopathy, commonly associated with thrombophilia, may be a cause of neurological deficit in childhood.
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Affiliation(s)
- T Yee Khong
- Department of Histopathology, Women's and Children's Hospital, North Adelaide SA 5006, Australia.
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Matalon ST, Shoenfeld Y, Blank M, Yacobi S, von Landenberg P, Ornoy A. Antiphosphatidylserine Antibodies Affect Rat Yolk Sacs in Culture: a Mechanism for Fetal Loss in Antiphospholipid Syndrome. Am J Reprod Immunol 2004; 51:144-51. [PMID: 14748841 DOI: 10.1046/j.8755-8920.2003.00140.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PROBLEM A variety of reproductive impairments have been reported in the context of the antiphospholipid syndrome (APS). APS is associated with the presence of antibodies to negatively charged phospholipids that may affect the outcome of pregnancy. METHOD OF STUDY Rat embryos were cultured within their yolk sacs. The effects of two antiphosphatidylserine monoclonal aPS antibodies (HL5B, RR7F) regarding their influence on growth and apoptotic events of the yolk sacs, as well as on growth and the morphology of the embryos, were studied. RESULTS Exposure of rat embryos and their yolk sacs to aPS inhibited yolk sac growth. Moreover, increased number of apoptotic events of giant cells in the aPS-exposed ectoplacental cone was found in comparison with control IgG-exposed giant cells (P < 0.05). No significant damage was observed in the embryos. CONCLUSIONS The results suggest that aPS affect growth and apoptosis of rat ectoplacental cone.
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Affiliation(s)
- Shelly Tartakover Matalon
- Department of Anatomy and Cell Biology, Laboratory of Teratology, Hebrew University Hadassah Medical School, Jerusalem
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31
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Kanellopoulos-Langevin C, Caucheteux SM, Verbeke P, Ojcius DM. Tolerance of the fetus by the maternal immune system: role of inflammatory mediators at the feto-maternal interface. Reprod Biol Endocrinol 2003; 1:121. [PMID: 14651750 PMCID: PMC305337 DOI: 10.1186/1477-7827-1-121] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2003] [Accepted: 12/02/2003] [Indexed: 11/10/2022] Open
Abstract
The adaptive immune system of placental mammals has evolved to tolerate the fetus. Rejection of the fetus by adaptive immune responses is therefore a rare event, with abortion being caused more frequently by inflammation in the placenta. This review will cover recent aspects of immune privilege and the innate immune system at the feto-maternal interface, citing examples of the role played by microbial infections in fetal demise.
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Affiliation(s)
| | - Stéphane M Caucheteux
- Institut Jacques Monod, CNRS UMR 7592, Universités Paris 6 & 7, 2 place Jussieu, 75251 Paris Cedex 5, France
| | - Philippe Verbeke
- Institut Jacques Monod, CNRS UMR 7592, Universités Paris 6 & 7, 2 place Jussieu, 75251 Paris Cedex 5, France
| | - David M Ojcius
- Institut Jacques Monod, CNRS UMR 7592, Universités Paris 6 & 7, 2 place Jussieu, 75251 Paris Cedex 5, France
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