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Las respuestas inmunológicas maternas al feto en el embarazo temprano y el aborto espontáneo recurrente
I L Sargent1, T Wilkins, C W Redman
1Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford.
Lancet (London, England)
|November 12, 1988
Resumen
Al investigar los abortos espontáneos recurrentes, este estudio encontró cambios inmunológicos mediados por células en algunas mujeres. Sin embargo, los factores inmunes circulantes no se correlacionaron con el éxito del embarazo, lo que desafía las teorías existentes.
Área de la Ciencia:
- Inmunología Reproductiva Inmunología Reproductiva
- La medicina materno-fetal es una de ellas.
- Inmunogenética La inmunogenética.
Sus antecedentes:
- El aborto espontáneo recurrente (RSA) afecta a numerosas mujeres, con casos inexplicables que plantean desafíos de diagnóstico.
- Las respuestas inmunes maternas a los antígenos fetales (paternales) están implicadas en la patogénesis de la RSA.
- Las teorías existentes sugieren que el rechazo inmune o la falta de tolerancia inmune pueden causar RSA.
Objetivo del estudio:
- Investigar la inmunidad mediada por células maternas a los antígenos paternos en mujeres con abortos espontáneos recurrentes inexplicables.
- Evaluar el papel de los alloanticuerpos citotóxicos y la actividad de bloqueo sérico en el éxito del embarazo en RSA.
- Para determinar si los cambios en la reactividad inmune materna se correlacionan con la pérdida de embarazo recurrente.
Principales métodos:
- Se evaluó la inmunidad materna mediada por células a los antígenos paternos antes de la concepción, durante el embarazo temprano y en el aborto espontáneo en 18 mujeres con RSA y 10 controles.
- Se midió la producción materna de todos los anticuerpos citotóxicos maternos.
- Se evaluó el efecto de bloqueo de sueros maternos en la activación de linfocitos maternos.
Principales resultados:
- No se observó una reactividad celular materna mediada consistente a los antígenos paternos en el embarazo temprano normal o en la mayoría de los casos de SARR.
- Se detectaron células citotóxicas circulantes en el aborto espontáneo en un tercio de las mujeres con SAR.
- No se encontró correlación entre la producción de anticuerpos citotóxicos, la actividad de bloqueo sérico y los resultados del embarazo.
Conclusiones:
- La reactividad inmune mediada por células puede estar alterada en algunas mujeres que experimentan abortos espontáneos recurrentes.
- Los factores de bloqueo inmunológico circulante no parecen ser relevantes para el éxito del embarazo en RSA.
- El mecanismo por el cual la inmunización materna con leucocitos paternos previene la RSA sigue sin ser explicado por estos hallazgos.
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