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Effect of immunoglobulin therapy on analysis of T helper (Th) frequencies and TNF-alpha in recurrent spontaneus aborters

Background: The T helper (Th) 1 reaction mainly triggers the inflammatory response with increase of tumor necrosis factor-alpha (TNF-alpha), interferon-gamma (INF-gamma) and IL-2, which contribute to trophoblast toxicity and pregnancy failure in women with recurrent spontaneous abortion (RSA). In the present study, was investigated a possible effect of intravenous immunoglobulin therapy (IVIg) on the precursors of T helper frequencies (fThp) and TNF-alpha and IL-2 cytokines in RSA patients. Methods: 45 women with history of unexplained three and more recurrent spontaneous abortion (RSA) was treated with intravenous immunoglobulin (IVIg), after conception in the prevention of RSA. The birth of child was considered a successful outcome. Study group for Thp frequencies consisted of 12 RSA treated women. Peripheral blood samples were collected in serial order, before and after therapy. Control group (n=15) of healthy women were compared for cytokine level and in that group 5 women were measured fThp. Ratios were compared between pre- and post- infusion in samples. Results: The success rates were 76% after therapy. A decrease of Thp frequencies were present in group of patients after second administration of IVIg at significant level (p=0, 02). Significantly increased concentration of the TNF-alpha was found in RSA as compared with successful pregnancy. In abortion– prone women who had a successful pregnancy, lower concentrations of TNF-alpha were found as compared with abortion-prone women who had another abortion (p=0, 017). Conclusion: Our results suggest that IVIg therapy have effect on alteration in alloimmune response which contributes pregnancy failure in RSA women. Supporting the notion that Th-1 is associated with unsuccessful pregnancy, IVIg administration modifies and enhances successful pregnancy.

spontaneous aborters; immunoglobulin therapy; Th frequency; TNF-alpha

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