TITLE:
Recurrent Spontaneous Abortion of Immune Origin and HLA Sensitization Immunotherapy
AUTHORS:
Isabela Mansur Bandeira, Juliana Vasconcelos, Thiago Luiz Bandeira, Jorge Oliveira, Carla Goulart, Aderbal Sabra, Luiz Werber-Bandeira
KEYWORDS:
Spontaneous Abortion, Immunotherapy, Pregnancy, Maternal-Fetal Relationships
JOURNAL NAME:
Advances in Reproductive Sciences,
Vol.10 No.1,
February
22,
2022
ABSTRACT: Introduction:Spontaneous abortion is defined as pregnancy loss before the twentieth week and Recurrent Spontaneous Abortion (RSA) is defined as at least three spontaneous and successive pregnancy losses in the same period. Among the different types of immunological causes, this study refers specifically to the alloimmune cause. Women with RSA of alloimmune cause share agreater number of Human Leukocyte Antigen (HLA) with their husbands,leading to the inhibition of the production of anti-paternal asymmetric blockingantibodies, which would protect embryonic cells. Objectives: To evaluate theeffect of immunotherapy with paternal HLA-sensitizing mononuclear cells in cases of RSA through the positivity of thecross-matchtest and its efficacy in pregnancy success. Patients and Methods: Written consent was obtained, 12 couples with a history of RSA presenting negative cross-match were includedin the study. Blood samples were collected from the couple for cross-matching and the separation of paternal mononuclear cells. Immunotherapy was performed with paternal mononuclear cells intradermally in the wives’ arms onday (D) 0, D15 and D30. After the third dose, a second evaluation of thecross- match tests was performed. Results and Discussion: The age of the wivesranged from 28 to 41 years, with a mean of 34.5 years. Thetwelve couples had a negativecross-matchtest (100%). Eleven couples (96.6%) tested positive in thecross- matchtest after immunotherapy. Of these, 10 (90.9%) had successful pregnancies. Immunotherapy with paternal mononuclear cells showed an excellentability to sensitize the maternal immune system, with positive cross-match, resulting in a successful pregnancy.