After 12 consecutive miscarriages, a patient received immunosuppressive treatment and delivered an intact baby

Nakagawa, Koji; Kuroda, Keiji; Sugiyama, Rikikazu; Yamaguchi, Koushi

doi:10.1002/rmb2.12040

Cited by 21 publications

(13 citation statements)

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“…An aberrantly high Th1/Th2 cell ratio during the preconception period leads to the reproductive failure [ 30 , 37 ]. Our results showed that 41.9% of Japanese infertile patients with the VD insufficient and deficient groups had 10.3 or more in Th1/Th2 cell ratios, suggesting that nearly half of the infertile patients without sufficient VD levels had impaired immunologic tolerance.…”

Section: Discussionmentioning

confidence: 99%

Vitamin D Regulates Maternal T-Helper Cytokine Production in Infertile Women

Ikemoto

Kuroda

Nakagawa³

et al. 2018

Nutrients

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Vitamin D (VD) deficiency is associated with reproductive failure. However, the relationship between VD and maternal immunity remains unclear. We investigated the clinical efficacy of VD in maternal T-helper (Th) cytokines in 276 infertile women and examined for Th1 and Th2 cells based on the deficient, insufficient, and sufficient serum 25-hydroxyvitamin D3 (25[OH]VD) levels (<12, 12–30, and >30 ng/mL, respectively). Most infertile women had a low-level of VD (87.3%). Immunological tests of pre-/post-VD supplementation were performed in patients who were deficient and insufficient in VD. Of 23 patients, 11 (47.8%) exhibited sufficient VD levels after supplementation. Th1/Th2 cell ratio in patients with insufficient VD was significantly decreased after supplementation (p = 0.004). After supplementation, serum 25(OH)VD levels of the patients: 11 in the sufficient group showed significant decreases in Th1 cell level and Th1/Th2 cell ratio (p = 0.032 and 0.010, respectively), whereas no significant differences in Th1/Th2 cell ratio were recognized in the insufficient group. Furthermore, mid-luteal endometrial biopsies (n = 18) were processed for primary cultures and measured interferon [IFN]-γ and interleukin [IL]-4 in condition media. Decidualizing cultures with 1,25-dihydroxvitamin D3 (1,25[OH]2VD) decreased IFN-γ. Sufficient VD supplementation in women with insufficient VD may optimize maternal T-helper cytokines during pregnancy via rebalancing the Th1/Th2 cell ratio.

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Section: Discussionmentioning

confidence: 99%

Vitamin D Regulates Maternal T-Helper Cytokine Production in Infertile Women

Ikemoto

Kuroda

Nakagawa³

et al. 2018

Nutrients

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“…Tacrolimus, an immunosuppressant, has been demonstrated to suppress immunological rejection by inhibiting cytotoxic T cell generation, alloantigen-induced lymphocyte proliferation, and the production of IL-2 and IFN-γ ( 195 ). It has been used as a plausible treatment for patients with RIF who have an elevated Th1/Th2 ratio and appears to improve pregnancy outcomes ( 196 , 197 ). However, further evidence is required to support the use of tacrolimus for RIF.…”

Section: Discussionmentioning

confidence: 99%

Recurrent implantation failure: A comprehensive summary from etiology to treatment

Gao

2023

Front. Endocrinol.

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Implantation is the first step in human reproduction. Successful implantation depends on the crosstalk between embryo and endometrium. Recurrent implantation failure (RIF) is a clinical phenomenon characterized by a lack of implantation after the transfer of several embryos and disturbs approximately 10% couples undergoing in vitro fertilization and embryo transfer. Despite increasing literature on RIF, there is still no widely accepted definition or standard protocol for the diagnosis and treatment of RIF. Progress in predicting and preventing RIF has been hampered by a lack of widely accepted definitions. Most couples with RIF can become pregnant after clinical intervention. The prognosis for couples with RIF is related to maternal age. RIF can be caused by immunology, thrombophilias, endometrial receptivity, microbiome, anatomical abnormalities, male factors, and embryo aneuploidy. It is important to determine the most possible etiologies, and individualized treatment aimed at the primary cause seems to be an effective method for increasing the implantation rate. Couples with RIF require psychological support and appropriate clinical intervention. Further studies are required to evaluate diagnostic method and he effectiveness of each therapy, and guide clinical treatment.

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“… 39 In our study, vitamin D replacement also decreased the high Th1/Th2 cell ratio in approximately 90% of women, including 35.7% with a normalized Th1/Th2 cell ratio after supplementation. Tacrolimus treatment for women with RPL has been reported, 57 , 58 but the evidence is still insufficient. Of the 30 pregnant women with tacrolimus intake for high Th1/Th2 cell ratios even after vitamin D supplementation, 21 (70.0%) reached a live birth in the first pregnancy.…”

Section: Discussionmentioning

confidence: 99%