new immunotherapy in treatment of
recurrent spontaneous abortion
Department of Gynecology and Obstetrics – “MEDICA CENTER” – Novosadska 1/c, 18000 Nis, Serbia and
Recurrent spontaneous abortion (RSA) is serious health problem affecting 2–5% of reproducing couples
worldwide. It has long been suspected that nearly 80% of the unexplained RSAs are due to immunologic causes.
Although the major tissue confronting the mother’s immune system is the placental villous trophoblast, the
immunological risk to the developing embryo is not great until the time of implantation. In addition, trophoblast is not
sensible to lysis by NK cells, TNF-α or macrophages, but may be killed by lymphokine activated NK cells (LAK) and may
undergo apoptosis in response to TNF-α and/or IFN-γ in vitro. The two most commonly used treatments for RSA are
intravenous immunoglobulin (IVIg) and alloimmunization with partner’s leukocytes (LIT). We promote vitamin D3 as
new immunomodulatory agent in treatment of RSA. Different mechanisms have been proposed to account for the
immunosuppressive effect of 1α, 25-dihydroxy-vitamin-D3 (VD3). Portion of the VD3 activity involves the downregulation
of IL-2, IFN-γ and TNF-α genes transcription. Because immunomodulatory effects of VD3 are very similar to IL-
10 effects, acting of VD3 in immunotherapy of RSA syndrome, preeclamptic and eclamptic pregnancy, as well as PIH
syndrome, is very reasonable. We propose using of VD3 as immunotherapy or adjuvant therapy in combination with
classic immunotherapies of endangered pregnancies.
Notes: Article submitted by author. Article originally published in Medical Hypotheses (2004) 63, 250–253.