Paternal Leucocyte Injections in Recurrent Spontaneous Abortion

Reznikoff-Etievant, MarieF.; Durieux, Isabelle; Huchet, J.; Salmon, Charles T.; Netter, A

doi:10.1016/s0140-6736(87)91155-x

“…Hence, there is no need for treatment before confirmation of pregnancy. (c) If 'blocking' antibodies are the protective agent, they can be made available also for 'nonresponders' to immunization with leukocytes who are considered to have a poor pregnancy outcome [9,10]. (d) HLA immunization which occurs in almost all patients after leukocyte therapy and is potentially hazardous to the mother in case of future blood transfusions or transplantation, can be avoided.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Recurrent Spontaneous Abortion by Intravenous Immunoglobulin

Mueller‐Eckhardt

¹

,

Heine

²

,

Neppert

³

et al. 1989

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Intravenous immunoglobulin (IVIG) treatment was attempted as a novel therapeutic approach for unexplained recurrent spontaneous abortions (RSA) occurring in the first trimester of pregnancy. Twenty women with a history of RSA were treated with IVIG during pregnancy. Therapy was commenced at week 5 of gestation with 1 dose of 0.5-0.6 g IVIG/kg body weight. Infusions were repeated every 3 weeks (0.3-0.4 g/kg) and terminated by week 22 to 24. Of 20 women, 11 delivered healthy infants at term. 5 women are still pregnant, 3 in the third trimester. Only 3 patients suffered abortions and 1 presented with ectopic pregnancy. The overall success rate was 82-86%. Thus, the therapeutic effect of IVIG is comparable to that of the conventional transfusion/vaccination regimen with allogeneic leukocytes, but avoids the risk of transmission of infections and/or HLA immunization, has no major adverse effects and is applicable to 'nonresponders'.

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“…Immunization of the mother with paternal lymphocytes has been investigated as a technique to induce immune tolerance. This procedure also known as alloimmunization has been in use since 1970's [2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17][18][19]. Many groups working in different countries reported positive results of clinical trials, some of which in addition to paternal cell immunization also used third party donor leukocytes, trophoblast membranes, and intravenous immune globulin as a source of alloantigens.…”

Section: To Reject or Not Reject: Alloimmuniza-tion Is The Answermentioning

confidence: 99%

AIDS Vaccines and Reproductive Immunology

Bourinbaiar¹,

Jirathitikal²,

Silin³

et al. 2007

CIR

0

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It may appear that problems of reproductive immunology have little in common with issues of treatment and prevention of AIDS. However, the certain aspects of HIV immunopathogenesis are closely related to problems faced by reproductive immunologists. The development of prophylactic and therapeutic AIDS vaccines would greatly benefit from acquired experience in immune regulation of reproductive dysfunction. The spermatozoa and HIV are foreign intruders that must enter the host cell, oocyte or T-lymphocyte, in order to start the replication process. The immune responses of the host organism against fertilized egg or HIV-impregnated lymphocyte must be similar, since in theory they are directed against alloantigens presented by such cells. This paper attempts to bring together the recent advances in AIDS field with progress made in the physiology and pathology of reproduction in humans, especially in the domain of immunotherapy and prevention of recurrent spontaneous abortions (RSA). It is our opinion that the lessons learned from alloimmunization trials of infertile women are relevant to prophylactic and therapeutic strategies for HIV infection.

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“…(b) The protective principle of IVIG is available immediately after infusion. Hence, there is no need for treatment before confirmation of pregnancy, (c) If "block ing' antibodies are the protective agent, they can be made available also for "nonresponders' to immunization with leukocytes who are considered to have a poor pregnancy outcome [9,10]. (d) HLA immunization which occurs in almost all patients after leukocyte therapy and is potential ly hazardous to the mother in case of future blood trans fusions or transplantation, can be avoided.…”

Section: Side Effects Of Ivig Treatmentmentioning

confidence: 99%

“…The reported success rates vary between 70 and 100% [2][3][4][5][6][7][8][9][10], but its mechanism is not yet fully understood [for review, 11]. According to the prevail ing hypothesis it is assumed that 'blocking' antibodies or factors, normally produced by the mother's immune system to protect the fetus against immunological rejection, are absent in patients with RSA, but can be stimulated by transfusion/vaccination with allogeneic leukocytes [1,3,4,[6][7][8][9]11], The formation of lymphocytotoxic and/or noncytotoxic antibodies which inhibit Fc-rosette formation [12,13], immune phagocytosis [13,14] or mixed lymphocyte culture [4,6,8,15] is considered to be an indicator of effective immunization after leukocyte therapy and of a successful outcome of pregnancy [9,10]. Hence, we hy pothesize that intravenous immunoglobulin (IVIG) pro cessed from a large pool of donors should contain pre formed antibodies of similar specificity and therefore might be effective by 'passive immunization' in patients with RSA.…”

Section: Introductionmentioning

confidence: 99%

Prevention of Recurrent Spontaneous Abortion by Intravenous Immunoglobulin

Mueller‐Eckhardt¹,

Heine²,

Neppert³

et al. 1989

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Intravenous immunoglobulin (IVIG) treatment was attempted as a novel therapeutic approach for unexplained recurrent spontaneous abortions (RSA) occurring in the first trimester of pregnancy. Twenty women with a history of RSA were treated with IVIG during pregnancy. Therapy was commenced at week 5 of gestation with 1 dose of 0.5-0.6 g IVIG/kg body weight. Infusions were repeated every 3 weeks (0.3-0.4 g/kg) and terminated by week 22 to 24. Of 20 women, 11 delivered healthy infants at term. 5 women are still pregnant, 3 in the third trimester. Only 3 patients suffered abortions and 1 presented with ectopic pregnancy. The overall success rate was 82-86%. Thus, the therapeutic effect of IVIG is comparable to that of the conventional transfusion/vaccination regimen with allogeneic leukocytes, but avoids the risk of transmission of infections and/or HLA immunization, has no major adverse effects and is applicable to ‘nonresponders’.

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Paternal Leucocyte Injections in Recurrent Spontaneous Abortion

Cited by 17 publications

References 4 publications

Prevention of Recurrent Spontaneous Abortion by Intravenous Immunoglobulin

Prevention of Recurrent Spontaneous Abortion by Intravenous Immunoglobulin

AIDS Vaccines and Reproductive Immunology

Prevention of Recurrent Spontaneous Abortion by Intravenous Immunoglobulin

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