妊娠初期における胎児に対する母親の免疫反応と,再発性流産による流産

I L Sargent¹, T Wilkins, C W Redman

¹Nuffield Department of Obstetrics and Gynaecology, John Radcliffe Hospital, Oxford.

Lancet (London, England)

|November 12, 1988

まとめ

繰り返し発生する自発性中絶を調査したこの研究では,一部の女性の細胞媒介免疫変化が発見されました. しかし,循環する免疫因子は妊娠の成功と相関せず,既存の理論に異議を唱えた.

科学分野:

生殖免疫学生殖免疫学
妊産婦・胎児医学について
免疫遺伝学免疫遺伝学とは

背景:

再発性自発性中絶 (RSA) は,多くの女性に影響を与え,原因不明の症例は診断上の課題をもたらす.
胎児 (父親) の抗原に対する母親の免疫反応は,RSAの病原性に関与しています.
既存の理論は,免疫拒絶または免疫耐性の欠如がRSAを引き起こす可能性があることを示唆しています.

研究の目的:

原因不明の再発性自発性中絶の女性における父性抗原に対する母細胞媒介免疫を調査する.
RSAにおける妊娠成功における細胞毒性アロアンチボディと血清阻害性の役割を評価する.
妊婦の免疫反応の変化が再発性妊娠中絶と相関するかどうかを判断する.

主な方法:

妊娠前,妊娠初期,妊娠中絶の際に,RSA患者18人,対照患者10人の妊婦で,父親の抗原に対する母細胞媒介免疫を評価した.
測定された母細胞毒性アロ抗体の産生.
母親のリンパ球活性化に対する母親の血清の阻害効果を評価した.

主要な成果:

正常な妊娠初期またはほとんどのRSA症例では,父親の抗原に対する一貫した母細胞媒介反応は観察されなかった.
循環中の細胞毒性細胞は,RSAを持つ女性の3分の1の妊娠中絶時に検出されました.
細胞毒性抗体生成,血清阻害活性,妊娠の結果との間には相関が認められなかった.

結論:

細胞媒介の免疫反応性は,再発性自発性中絶を経験している一部の女性に変化することがあります.
循環する免疫的阻害因子は,RSAにおける妊娠の成功と関係がないようです.
父の白血球による母体免疫がRSAを予防するメカニズムは,これらの発見によって説明されていないままです.

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