Massive Intravenous Immunoglobulin Treatment in Women with Four or More Recurrent Spontaneous Abortions of Unexplained Etiology: Down‐Regulation of NK Cell Activity and Subsets

Abstract

MIVIg treatment was effective in all 14 pregnancies from RSA women of unexplained etiology, excluding 4 abortions with chromosome abnormality. Peripheral NK cell activity and subsets were suppressed by MIVIg treatment.

Effect of IgG Therapy on Lymphocyte Subpopulations in the Peripheral Blood of Kuwaiti Women Experiencing Recurrent Pregnancy Loss

“…The second mechanism is the suppression of NK cell activity by IVIg. In a recent study, elevated NK cell activity of women at risk for RPL significantly decreased after incubation of T lymphocytes with IgG [18] whereas NK cell activity of normal pregnancy was unaltered. In the first trimester, the normal pregnancy group manifested T-lymphocyte activation concomitant with increased expression of several T-cell activation markers ( fig.…”

“…The differences in the results may be explained by the different criteria for RPL applied. While some investigators defined RPL as three previous consecutive miscarriages, others used two [18]. In this study, we evaluate the effects of IVIg infusion on peripheral T-cell subpopulations in women with RPL.…”

Intravenous immunoglobulin G in women with reproductive failure: The Korean Society for Reproductive Immunology practice guidelines

“…Another study also showed that IVIG modifies the Th1/Th2 balance during early pregnancy (4–5 gestational weeks) in women with RPL without other etiologies [31]. IVIG was also effective in reducing the increased peripheral blood NK cell counts and/or NK cell activities in women with unexplained RPL [323334]. Moraru et al [35] reported that IVIG improved the live-birth rate in women with reproductive failure who had high levels of NK cells.…”

“…Recently, Lee et al [36] demonstrated that the live-birth rate was significantly higher in cases of idiopathic RPL in women with cellular immune abnormalities treated with IVIG than in cases of idiopathic RPL in women who were not treated with IVIG, as reported in other studies (82% vs. 42%). The possible mechanisms of action of IVIG in RPL are (1) the neutralization of cytotoxic antibodies, (2) the downregulation of NK cell numbers and activity, (3) the regulation of Th1/Th2 balance, and (4) the expansion of regulatory T cell populations [333738]. …”

The Management of Antiphospholipid Antibodies Affected Pregnancy

“…Yamada et al, first performed a high dose IVIg therapy (20 g/day, 5 consecutive days, total 100 g) in early pregnancies of women with unexplained severe RSA, demonstrating a high live birth rate (62)(63)(64). Carreras et al (50) performed IVIg therapy (400 mg/kg・day, 5 consecutive days at 17 GW; and 2 days at 22, 27 GW) in APS women.…”