Fertility rate in recurrent miscarriage (RPL) patients with anti-ANA antibodies and without anti-ANA before and after lymphocyte therapy in comparison to control groups

Abstract

In recent studies, the discussion and exchange of opinions in the field of immunotherapy for reproductive patients, especially those with recurrent miscarriages (RPL), is very interesting. Limited studies are dedicated to investigating the effect of intradermal lymphocyte therapy in improving the pregnancy rate in women with RM. Therefore, we decided to investigate the effect of intradermal lymphocyte therapy on pregnancy success in patients with frequent miscarriages who have or lack ANA autoantibody separately. Methods: 200 patients with recurrent miscarriage and 50 healthy people with successful pregnancy were considered as the control group for this study. To prepare peripheral blood mononuclear cells (PBMCs) from peripheral blood, first 10 ml of heparinized blood is taken from patients and peripheral blood mononuclear cells are isolated using Ficol 1.077. According to the standard protocol, 2 x 107 were injected subcutaneously to patients with recurrent miscarriage. The number of injections is three times with one-month intervals. Flow cytometry was also used to check the ratio of Th1/Th2 and NK cells. Fertility and live birth rates were also investigated separately in patients who were positive or negative in terms of ANA. Result: Compared to the control group and the group of patients with recurrent miscarriage, the expression level of Th1/Th2 cell ratio and NK cells frequency in the group of patients with recurrent miscarriage increased significantly compared to the control group. After the injection of subcutaneous lymphocyte therapy to two groups of patients, the number of Th1/Th2 cells decreased significantly only in the group of patients who were negative in terms of autoantibodies. Also, the rate of fertility and live birth in the group of patients who were ANA negative compared to the group of ANA positive patients increased significantly after lymphocyte therapy.