Immunologic aspects of recurrent abortion and fetal death.
Immunologic aspects of recurrent abortion and fetal death.
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DOI：
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发表时间：
1987-10
影响因子：
7.2
通讯作者：
Scott;Rote Ns;D. Branch
中科院分区：
文献类型：
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作者：
Scott;Rote Ns;D. Branch
虽然机制，防止排斥的概念不完全理解，最近的证据表明，母亲的免疫异常可能会导致反复流产。与抗磷脂抗体相关的自身免疫性疾病有时会导致蜕膜和胎盘血管异常;大多数此类女性通过皮质类固醇和低剂量阿司匹林治疗可成功妊娠。母体对父本或滋养层同种异体抗原的异常免疫反应，阻断抗体或抑制细胞的产生不足，也有牵连。用父亲或第三方白细胞对这些患者进行免疫接种导致了大量活产。然而，所有治疗方案的作用机制、有效性和安全性仍存在争议。目前对复发性流产患者的评估建议包括传统的非免疫因素和最近认识到的自身免疫因素的诊断和适当的治疗。其余没有可检测到的重复性流产原因的患者可以转诊到研究中心进行进一步的免疫学评估和实验性免疫治疗。
Although mechanisms that prevent rejection of the conceptus are incompletely understood, recent evidence suggests that maternal immunologic aberrations may cause repeated abortions. Autoimmune conditions associated with antiphospholipid antibodies sometimes produce vascular abnormalities in the decidua and placenta; successful pregnancies can be achieved in most of these women by treatment with corticosteroids and low-dose aspirin. Abnormal maternal immune responses to paternal or trophoblast alloantigens, with insufficient production of blocking antibodies or suppressor cells, have also been implicated. Immunization of these patients with paternal or third-party leukocytes has resulted in a number of live births. However, the mechanism of action, effectiveness, and safety of all treatment regimens remain controversial. Present recommendations for the evaluation of recurrent-abortion patients include diagnosis and appropriate treatment of traditional nonimmunologic and more recently recognized autoimmune factors. The remaining patients with no detectable cause for repetitive pregnancy loss are candidates for referral to research centers for further immunologic evaluation and experimental immunotherapy.