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Recurrent spontaneous abortion (RSA) is serious health problem affecting 2–5% of reproducing couples …


Biology Articles » Reproductive Biology » 1-alpha,25-dihydroxy-vitamin-D3 asnew immunotherapy in treatment ofrecurrent spontaneous abortion » Current models of immunotherapy inpatients with RSA past

Current models of immunotherapy inpatients with RSA past
- 1-alpha,25-dihydroxy-vitamin-D3 asnew immunotherapy in treatment ofrecurrent spontaneous abortion

Various forms of immunotherapy have been introduced to treat couples suffering from recurrent unexplained abortions. IVIg is seen to suppress antiphospholipid antibodies and is the therapy used when conventional anti-coagulant or immunosuppressive treatment is ineffective. It has been noted that the IVIg infusion contains anti-idiotypic antibodies, which inhibit the binding of anti-phospholipid antibodies to corresponding antigens and inactivate idiotype bearing B cells. Alteration of T cell subsets, modulation of cell mediated responses, and blockade of the immunoglobulin FcgR on monocytes, as well as reduction of the NK cytotoxicity have been reported [13]. Down-regulation of CD56+ and CD56+ CD16+ NK cells have been seen in women treated with IVIg infusion. The infusion is effective in enhancing the percentage of live births among women experiencing RSA. Recent data suggest that IVIg therapy is useful in maintaining pregnancies among women with a history of RSA who lose karyotypically normal embryos and who demonstrate elevated levels of circulating NK cells [11,13].

The application of LIT involves immunizing the mother with leukocytes from either paternal or third party origin. The LIT has been implicated in an attempt to produce a maternal immunoglobulin effectors believed necessary for pregnancy maintenance [5,14]. The foundations for LIT is composed of three suppositions; (a) there is a maternal immune response to the conceptus that develops in all pregnancies that must be blocked, (b) blocking factors develop in all successful pregnancies and (c) in the absence of blocking antibodies, rejection of the fetus occurs [5,14].

The rationale for using seminal plasma in treatment of RSA is provided in the concept that the mammalian female responds to antigens present not only on the trophoblast but also in seminal plasma. The antiphospholipid syndrome, in women who suffer from RSA, has been successfully treated using aspirin, heparin, and prednisone or combination of the three [5–7].


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