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CLINICAL LABORATORY INDICATORS OF PREGNANT WITH ANTIPHOSPHOLIPID SYNDROME IN COMPLEX THERAPY WITH USING INTRAVENOUS IMMUNOGLOBULIN

https://doi.org/10.17749/2070-4968.2015.9.3.011-016

Abstract

Objective: to study clinical and laboratory indicators of influence of intravenous immunoglobulin (IV-Ig) in complex therapy of pregnant women with syndrome of fetal loss syndrome. Materials and methods. Study included 63 pregnant women with fetal loss syndrome caused by APS. They were divided into 2 groups depending on therapy. The patients in group I (n=35) - received anticoagulant, antiplatelet and antioxidant therapy. The patients in group II (n=28), in addition to conventional treatment received IV-Ig. Laboratory studies included determination of antiphospholipid antibodies lupus anticoagulant, concentration of anticardiolipin antibody, antibodies to β2-glycoprotein, annexin V, phrotrombin. Diagnosis of blood thrombophilia included determination of aggregate platelet function, molecular markers of thrombophilia - TAT (fragments of thrombin-antithrombin), D-dimer (fibrin polymerization). Evaluated the content of the main subpopulations of immune cells in the peripheral blood, the absolute and relative abundance of cells with the phenotype CD3 + (T-lymphocytes). Results. The results of laboratory and clinical studies of the IV-Ig in the treatment of fetal loss syndrome, which is caused by antiphospholipid syndrome. In the group of pregnant women who received therapy IV-Ig, marked decrease in levels antiphospholipid antibodies, markers of thrombophilia, reducing the frequency of pregnancy complications and improve perinatal indicators. Conclusion. It is noted that immune-modulating effect is probably related to its positive impact on the function of T-regulatory lymphocytes.

About the Author

V. I. Linnikov
City Center for Family Planning and Reproduction, Odessa, Ukraine, Medical Genetics Center "GerMedTeh", Odessa, Ukraine
Russian Federation
MD, professor, Senior scientific consultant, Medical Genetic Center «GerMedTech»


References

1. Makatsariya A.D., Bitsadze V.O., Khizroeva D.Kh., Makatsariya N.A., Yashenina E.V. Prakticheskaya meditsina. 2012; 5: 9-20.

2. Makatsariya A.D., Bitsadze V.O. Thrombophilia and antithrombotic therapy in obstetric practice [Trombofiliya i protivotromboticheskaya terapiya v akusherskoi praktike (in Russian)]. Moscow. 2003; 904 s.

3. Makatsariya A.D., Bitsadze V.O., Baimuratova S.M., Dolgushina N.V., Yudaeva L.S., Khizroeva D.Kh., Akin'shina S.V. Antiphospholipid syndrome – the immune thrombophilia in obstetrics and gynecology [Antifosfolipidnyi sindrom – immunnaya trombofiliya v akusherstve i ginekologii (in Russian)]. Moscow. 2013; 485 s.

4. Sel'kov A.V., Selyutin A.V. Laboratornaya diagnostika. 2008; 4: 19-21.

5. Sidel'nikova V.M. The usual pregnancy loss [Privychnaya poterya beremennosti (in Russian)]. Moscow. 2005; 304-307.

6. Yarilin A.A., Donetskova F.D. Regulyatornye T-kletki, zavisimye ot faktora FOXp3, i perspektivy ikh izucheniya pri beremennosti. Rus J. Immunol. 2005; 9: 149-152.

7. Branch D.W., Peaceman A.M., Silver R.K. A multicenter, placebo-controlled pilot study of intravenous immune globulin treatment of antiphospholipid syndrome during pregnancy. The Pregnancy Loss Study Group. Am J Obstet Gynecol. 2000; 182 (1): 122-127.

8. Carp H., Sapir T., Shoenfeld Y. Inravenous immunoglobulin and recurrent pregnancy loss. Clin. Rev. Allegy Immunol. 2005; 29 (3): 327-332.

9. Coulam C.D., Roussev R.G. Correlation of NK cell activation and inhibition markers with NK cytoxicity among women experiencing immunologic implantation failure after in vitro ferilization and embryotransfer. J. Ass. Reprod. Genet. 2003; 20: 58-62.

10. Guerin L.R. Regulatory T-cells and immune tolerance in pregnancy: a new target for infertility treatment? Human Reproduction Update. 2009; 15 (5): 535-571.

11. Chen M.L., Pittet M.J., Gorelik Regulatry I. T-cells suppress tumor-specific CD8 T-cell cytotoxity through TGF-b signals in vivo. Proc. Nath. Acaci. Sci USA. 2005; 102: 409-424.

12. Christiansen O.D. A randomized, double-blind, placebo-controlled trial of intravenous immunoglobulin in the prevention of recurrent miscarnage evidence for a therapeutic effect in women with secondry recurrent miscamage. Hum. Reprod. 2002; 17: 809-816.

13. Shoenfeld Y., Kutz U. IVIG therapy in autoimmunity and related disorders our experience with a large cohort of patients. Autoimmunity. 2005; 38 (2): 123-137.

14. Stricker R.B., Stenleitner A., Winger E.E. Intravenous immunoglobulin therapy for immunologic abortion. Clin. Appl. Rev. 2002; 43: 187-199.

15. Stephenson M. Inravenous immunoglobulin and idiopathic secondary recurrent miscarriage: a multicentered randomized placebocontrolled trial. M. Stephenson. Hum. Reprod. 2010; 25 (9): 2203-1209.

16. Tzronkowski P., Szit E., Mysliwska E. CD4+ CD25+ T-regulatory cells ingibit human cytotoxic activity of CTL and NK-cells in humans – impact of immunosensence. Clin. Immunol. 2006; 119: 307-312.

17. Triolo G. IVIG in pregnancy. Lupus. 2004; 13 (9): 731-736.


Review

For citations:


Linnikov V.I. CLINICAL LABORATORY INDICATORS OF PREGNANT WITH ANTIPHOSPHOLIPID SYNDROME IN COMPLEX THERAPY WITH USING INTRAVENOUS IMMUNOGLOBULIN. Obstetrics, Gynecology and Reproduction. 2015;9(3):11-16. (In Russ.) https://doi.org/10.17749/2070-4968.2015.9.3.011-016

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ISSN 2313-7347 (Print)
ISSN 2500-3194 (Online)