Anti‐Paternal Antibodies by Flow Cytometry in the Management of Alloimmunization on Recurrent Miscarriages

Abstract

Positive FCXM is closely associated with successful pregnancy outcome following immunotherapy. We propose that FCXM might be included in the routine laboratory tests for the management of recurrent miscarriages.

Immunotherapy with Paternal Lymphocytes for Recurrent Miscarriages and Unsuccessful in vitro Fertilization Treatment

“…In contrast, another randomized, multicenter double blind study could not find any therapeutic effects of AI in RA [11], substantially enhancing the critical evaluation of AI in the present Cochrane meta-analysis [1]. In view of Matsubayashi et al [14] and Clark et al [15], heterogeneity of the patient groups and methods of immunization in that study might have added to the diverging results. Our results of AI in women with RA clearly exceeded previously published success rates of 61.7% [6]: Our overall success rate was 75% when patients with <3 abortions were included and 73% in patients with ≥3 abortions.…”

“…From our data, the success rate of active AI is significantly above the statistical chance that women with RA without treatment will have a baby [14,15,21,37,38].…”

“…It is possible that the sensitivity of the CDC test is too low to use a negative result as a predictive test for a miscarriage. Matsubashi et al [14] have therefore suggested flow cytometry (flow cytometry crossmatch; FCXM) due to its higher sensitivity and higher predictive value for a successful pregnancy (75.9%) in FCXM-positive patients and for abortion (75.9%) in FCXM-negative patients.…”

“…Another test for the detection of antipaternal leukocyte antibodies is the erythrocyte antibody rosette inhibition (EAI) test [14] which indicates antibody formation against Fc receptors. This very laborious technique was not used in our study because after repeated immunization the results of the EAI test had been, as previously described by Grosse-Wilde and Kuhn [9], always positive [25].…”

Prevalence and qualitative properties of circulating anti–human leukocyte antigen alloantibodies after pregnancy: No association with unexplained recurrent miscarriage

“…In most of the earlier studies, cell-based techniques for alloantibody detection, such as leukoagglutination [2,21], CDC [1,5,12,13,22], or flow-cytometric cross-matching [26,27] were used to detect alloantibodies. A weakness of cell-based assays is their failure to distinguish between HLA-specific alloantibodies and antibodies directed to non-HLA antigens expressed on the surface of test lymphocytes.…”