Women with RSA demonstrate an abnormal cellular immune response by increasing peripheral natural killer cells and B cells as compared with normal controls.
In summary (1) Nonpregnant women with RSAs of unknown etiology have higher levels of CD56+ lymphocytes when compared to normal controls; (2) The levels of CD19+, CD56+, and CD56+/CD16+ PBL of pregnant women with RSA are significantly higher than those of multiparous pregnant normal controls; (3) Women with autoantibodies to phospholipids have significantly higher levels of elevated CD56+ and CD56+/CD16+ lymphocytes when compared to women without antiphospholipid antibodies; (4) Women with autoantibodies to nuclear components demonstrate higher numbers of CD19+/CD5+ cells compared to women without autoantibodies to nuclear components; (5) Idiopathic infertile women with multiple prior IVF failures demonstrate significantly higher levels of CD56+ pBL than normal fertile controls and the conception rate is much higher in those with CD56+ levels less than 12%; (6) Elevations of CD56+ lymphocytes to over 18% during a pregnancy is a good prognostic indicator of impending pregnancy loss. We have not seen a liveborn infant in women with levels of 18% or higher without IVIg therapy; and (7) Infertile and RSA women who fail alloimmune and autoimmune therapy have significant alterations in cellular and humoral immunity involving NK cells and CD19+/CD5+ B cells.
To the Editor: Age-specific normal limits for a number of vital signs and physiological parameters have not been established in the elderly population. The limits for younger adults are not always applicable because of ageassociated physiological changes and the increase of interindividual differences with age. 1 Regarding the respiratory system, there are few data on normal respiratory rate at rest (RR) and peripheral pulse oximetry values (SpO 2 ), which are major parameters in clinical practice and easy to measure, and become altered quickly in respiratory and cardiac diseases. (Increased respiratory rate is often the only visible sign of a respiratory infection.) 2,3 This was a cross-sectional study of 791 noninstitutionalized individuals aged 65 and older living in Spain to establish the limits of normal RR and SpO 2 in the elderly population.The sample was collected using multistaged probabilistic sampling and stratified according to sex, size of place of residence (rural, urban, or big city), and geographic location with a nonproportional age stratum (523 subjects aged ≥80). A sample of 576 participants was considered necessary to estimate RR and SpO 2 with 5% error and a design effect of 1.5.Survey data were collected between 2007 and 2009. The survey was carefully designed to reduce nonsampling errors, the survey takers received specific training, and the field work was thoroughly supervised.RR and the SpO 2 were measured with the participant in a seated position after a rest of at least 10 minutes. SpO 2 was measured using a pulse oximeter (9500; Nonin Medical, Plymouth, MN), and RR was measured by directly observing thoracic movements for a 30-second period. As a distraction maneuver, the survey takers pretended to measure the radial pulse, so that participants would not be aware that their respiratory rate was being measured. 3 All information about participants' medical background was collected as control variables.Two consecutive analyses were conducted. First, all participants with pathologies that proved to affect RR or SpO 2 independently in multivariable models were excluded. A subsequent more-restricted analysis was performed by excluding all individuals who had any clinical factor showing significant influence in bivariate analyses. Participants with dyspnea during the examination were excluded from all calculations.Normal RR limits were represented according to percentiles that delimit 95% of the sample (2.5-97.5) and percentiles that delimit 99% of the sample (0.5-99.5). Limits of SpO 2 were represented according to the first and fifth percentiles. Calculations were weighted according to age, sex, and size of place of residence.History of chronic obstructive pulmonary disease (COPD) was the only variable that independently influenced RR and SpO 2 in the multivariate models. Once individuals with COPD were excluded, the RR distribution appeared bell-shaped, with 0.67 kurtosis and 0.43 asymmetry, and was significantly different from the theoretical normal distribution according to the Kolmogor...
We previously reported elevation of natural killer (NK) cells in women with recurrent spontaneous abortion (RSA) of immune etiology. In this study, we investigated the effect of intravenous immunoglobulin G (IVIg) on peripheral blood NK activity in vivo in women with RSA. Blood was drawn prior to and 7-11 days after IVIg therapy in eight women with RSA. NK activity was measured using K562 as target cells for 51Cr-release assays. Serum IgG concentrations were also measured. All received 400 mg/kg/day of IVIg for 3 consecutive days. 1) Seven of eight women became pregnant. Five delivered a live born infant. Three out of five women (60%) who delivered a live born infant showed a significant inhibition of NK cytotoxicity post IVIg and the rest did not show any changes; 2) NK cytotoxicity was significantly increased in a woman who miscarried again; 3) A woman who miscarried a chromosomally abnormal fetus showed a significant inhibition of NK cytotoxicity after IVIg; and 4) Serum IgG concentration increased significantly from 9.3 +/- 3.0 mg/ml to 23.5 +/- 5.1 mg/ml post IVIg therapy. IVIg effectively inhibits peripheral blood NK activity in vivo. These results are consistent with our previous finding showing that IVIg inhibits NK cell activity in vitro. Women with RSA and elevated NK cells may benefit from IVIg treatment.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.