The Effects of IVIG on Exhausted T cells and Live Birth rate of Patients with Recurrent Pregnancy loss with Immunological Causes

Abstract

In this study, we investigated the effect of IVIG on the levels and function of exhausted T cell and exhausted regulatory T cells and pregnancy outcome in women with RM. Material and methods: 94 pregnant women with RM were enrolled in this study. All pregnant women had cellular immune abnormality in preconceptional evaluation. Blood was drawn at the time of positive pregnancy. On the same day, IVIG 400 mg/kg was administered intravenously for 44 patient. 50 other RM patients were included as no IVIG interfering control group. Following the first administration, IVIG was given every 4 weeks through 32 weeks of gestation. Peripheral blood was drawn after the last administration (32 weeks after pregnancy). Exhausted T cell, exhausted regulatory T cell and regulatory T cell population were evaluated before and after treatment in the two group. Results: IVIG down-regulated exhausted regulatory T cells population and function and up-regulated Treg cells population and function were significant in the treated group. Also IVIG treatment don’t effect on population and functionof Exhausted T cells. In contrast, no significant difference in exhausted T cell, regulatory T celland exhausted regulatory T cells population and function was observed in the untreated subjects before and after pregnancy. Pregnancy outcome in IVIG treated subjects was successful in 38 out of 44 RM women (86.3%). However, pregnancy outcome was successful in 21 out of 50 untreated RM women (42%).