Intravenous immunoglobulin (IVIG) treatment modulates peripheral blood Th17 and regulatory T cells in recurrent miscarriage patients: Non randomized, open-label clinical trial

Ahmadi, Majid; Abbaspour-Aghdam, Sanaz; Nouri, Mohammad; Babaloo, Zohreh; Farzadi, Laya; Ghasemzadeh, Aliyeh; Hamdi, Kobra; Movassaghpour, Ali Akbar; Jadidi‐Niaragh, Farhad; Afkham, Amir; Motallebnezhad, Morteza; Eghbal‐Fard, Shadi; Younesi, Vahid; Yousefi, Mehdi

doi:10.1016/j.imlet.2017.10.003

Cited by 37 publications

(35 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…In RM, standard investigations (parental karyotypes, uterine cavity exploration, screening for antiphospholipid [aPL] antibodies) fail to reveal an apparent cause for RM in ~50% of women. However, on the basis of animal models and clinical studies, several hypotheses have been proposed: an altered ovarian reserve, a progesterone defect, thrombotic and/or endothelial dysfunction, immunological disturbances, and chronic endometritis . Some of these possible mechanisms may be occur simultaneously in the same patient, e.g., in obese women at high risk for RM …”

Section: Pathophysiology Of Recurrent Miscarriagementioning

confidence: 99%

Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

Moreuil

Alavi

Pasquier

2019

Brit J Clinical Pharma

View full text Add to dashboard Cite

Recurrent miscarriage (RM) and vasculoplacental disorders, such as preeclampsia (PE), affect women of childbearing age worldwide. Vascular endothelial dysfunction and immunological impairment are associated with both RM and PE. To date, there is no effective or optimal therapeutic approach for these conditions. Notably, aspirin use is only partially effective in the prevention of PE. Hydroxychloroquine (HCQ) has demonstrated beneficial effects on disease flares, pregnancy outcomes and cardiovascular impairment in systemic erythaematosus lupus (SLE) through its immunomodulatory, vasculoprotective and antithrombotic properties. Here, in the context of the underlying physiological dysregulation associated with PE and RM, the beneficial properties and potential therapeutic efficacy of HCQ are reviewed in anticipation of the results of current and future trials. Two related trials addressing RM in the absence of maternal autoimmune disease are ongoing. Other trials addressing pregnancy outcomes in the presence of maternal autoimmune disease are forthcoming. In this review, we hypothesise that the immunological and endothelial effects of HCQ may be beneficial in the context of PE and RM, regardless of the maternal autoimmune status. K E Y W O R D S hydroxychloroquine, pregnancy, preeclampsia, recurrent miscarriage

show abstract

Section: Pathophysiology Of Recurrent Miscarriagementioning

confidence: 99%

Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

Moreuil

Alavi

Pasquier

2019

Brit J Clinical Pharma

View full text Add to dashboard Cite

show abstract

“…32 More recently, the intravenous (I.V.) 47,48 In this review, we will discuss the effects of IVIg therapy on women presenting with unexplained RSA and specifically the modulatory effects of IVIg on the balance between T helper 17 (Th17) and T regulatory (Treg) cells. [19][20][21][22] IVIg has demonstrated immune modulatory effects via the F(ab')2 fragment [33][34][35] and the Fc fragment.…”

Section: Introductionmentioning

confidence: 99%

“…16,[40][41][42][43][44][45][46] And, recent studies have shown the modulatory effect of IVIg on Treg/Th17 cells ratio enhancing Treg and decreasing Th17 cells response, and thereby improve the successful pregnancy rate in pregnant women with recurrent spontaneous abortion. 47,48 In this review, we will discuss the effects of IVIg therapy on women presenting with unexplained RSA and specifically the modulatory effects of IVIg on the balance between T helper 17 (Th17) and T regulatory (Treg) cells.…”

Section: Introductionmentioning

confidence: 99%

Modulatory effect of intravenous immunoglobulin on Th17/Treg cell balance in women with unexplained recurrent spontaneous abortion

Muyayalo

Mor

et al. 2018

American J Rep Immunol

View full text Add to dashboard Cite

Recurrent spontaneous abortion (RSA) is a growing problem worldwide. In a majority of cases, the cause remains unknown but there is increasing evidence that immunologic factors play an important role. Intravenous immunoglobulin (IVIg) therapy has been proposed to have immune modulatory effects and therefore been applicable for the treatment of patients with RSA. Although its efficacy is still controversial, several recent studies suggest that IVIg treatment may improve pregnancy outcomes. CD4 T cells and their related cytokines play an important role in maternal-fetal immune regulation, and an imbalance of Th17/Treg cell ratio has been proposed as a cause for RSA. We review the scientific evidence supporting a modulatory effect of IVIg on Th17/Treg cell balance and discuss the potential mechanisms how IVIg might enhance Treg cells function. We propose that correction of Th17/Treg cell dysregulation could be one of the mechanisms that can explain the positive therapeutic effects of IVIg therapy. Consequently, selecting patients with abnormal Th17/Treg cell ratios could increase the success of IVIg therapy.

show abstract

“…[22][23][24] In research studies, intravenous immunoglobulin G treatment and lymphocyte immunotherapy have commonly been applied to modulate the Treg/Th17 imbalance in pregnant women with RPL. [25][26][27] In a study using an abortion-prone mouse model, transfer of pregnancyinduced CD4 + CD25 + Treg cells was able to reverse the elevated abortion rate which was induced by IL-17. 28 The regulation of Th17/ Treg balance may be a novel and promising therapeutic strategy for patients with RPL.…”

mentioning

confidence: 99%

The role and mechanism of vitamin D‐mediated regulation of Treg/Th17 balance in recurrent pregnancy loss

Zhai

Zhou

et al. 2019

American J Rep Immunol

View full text Add to dashboard Cite

Problem Vitamin D has a pivotal role in regulating immune responses in women with recurrent pregnancy loss (RPL), but the underlying mechanism has not been completely clarified. This study aimed to determine the correlation between vitamin D and Treg/Th17 and the effects of vitamin D supplementation on Treg/Th17 balance in RPL patients. Methods of study The level of vitamin D was determined in women with normal pregnancy and RPL by electrochemiluminescence. The percentages of CD4+Foxp3+ Treg, CD4+IL‐17+ Th17, and CD4+Foxp3+IL‐17+ T cells were determined by flow cytometry before and after vitamin D supplementation. Changes about Treg/Th17 balance after culturing with active vitamin D in vitro were determined. Vitamin D metabolic activity of peripheral blood mononuclear cells was also detected by RT‐PCR. Results Compared with normal pregnancy, both the level of vitamin D and the Treg/Th17 ratio were significantly decreased in women with RPL. There was a positive correlation between the level of vitamin D and the Treg/Th17 ratio in the RPL group. Within the RPL group, those who received 2 months of vitamin D supplementation showed a significantly increased Treg/Th17 ratio compared with those without vitamin D supplementation. In vitro analysis showed that adding different concentrations of active vitamin D increased the Treg/Th17 ratio, also the mRNA levels of the vitamin D receptor and the metabolic enzyme CYP24A1 increased significantly. Conclusion The occurrence of RPL may be related to vitamin D insufficiency and Treg/Th17 imbalance. The Treg/Th17 imbalance seen in women with RPL can be restored by vitamin D supplementation both in vivo and in vitro. The effects of vitamin D on the immune regulation of RPL indicate that vitamin D might be used as an alternative therapy in the future.

show abstract

Intravenous immunoglobulin (IVIG) treatment modulates peripheral blood Th17 and regulatory T cells in recurrent miscarriage patients: Non randomized, open-label clinical trial

Cited by 37 publications

References 45 publications

Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage

Modulatory effect of intravenous immunoglobulin on Th17/Treg cell balance in women with unexplained recurrent spontaneous abortion

The role and mechanism of vitamin D‐mediated regulation of Treg/Th17 balance in recurrent pregnancy loss

Contact Info

Product

Resources

About