母-胎免疫识别低下型反复自然流产配偶淋巴细胞免疫疗法的改进

比较配偶淋巴细胞诱生后与非诱生免疫疗法 ,对于母 胎免疫识别低下型反复自然流产 (RSA )的临床疗效 ,并分析其疗效机制。 194例母 胎免疫识别低下型RSA患者随机分成 2组 ,分别采用经体外诱生的或未经体外诱生的配偶淋巴细胞对其进行皮内多点注射免疫治疗。分别观察随后的妊娠结局、封闭抗体水平。经配偶淋巴细胞免疫后 ,体外诱生的淋巴细胞免疫组妊娠成功率为 90 0 % ;未经体外诱生的淋巴细胞免疫组妊娠成功率为 84 8%。对于封闭抗体各项指标分析结果显示 ,配偶淋巴细胞皮内免疫能有效促进RSA患者封闭抗体及其抗独特型抗体水平的升高 ;经体外诱生的配偶淋巴细胞免疫疗法能显著提高RSA患者外周血抗CD3 BE的水平。配偶淋巴细胞皮内免疫疗法通过刺激封闭抗体的产生 ,改善随后的妊娠预后 ,配偶淋巴细胞经体外诱生后作为免疫原 ,通过升高抗CD3封闭抗体水平 ,有助于改善妊娠预后。

Improvement of Paternal Lymphocyte Immunization to Recurrent Spontaneous Abortion of Insufficient Materno-Fetal Immuno-Recognition

To compare curative impact of immunization by IFN-γ in vitro inducing paternal lymphocytes or paternal lymphocytes without in vitro treatment to recurrent spontaneous aborters of insufficient materno-fetal recognition,and to investigate therapeutic mechanisms of the immunotherapy,the 194 recurrent spontaneous abortion (RSA) patients of insufficient materno-fetal recognition were randomly divided into two groups,one group were immunized by intradermal vaccination with their paternal lymphocytes without in vitro treatment,and another group were immunized with the IFN-γ in vitro inducing paternal lymphocytes. One course of treatment was immunizing for 3 times at an interval of 3～4 weeks. The resultant pregnant outcome,blocking antibodies (BE-Ab1),anti-idiotypic antibodies to blocking antibody (BE-Ab2),and the blocking antibodies recognized by FCM were surveyed after the immunization of one treating course. The successful rate of pregnancy was 90.0% of immunization with the IFN-γ in vitro inducing paternal lymphocytes,and 84.8% of immunization with the paternal lymphocytes without in vitro treatment. It was shown by analysis of the blocking antibodies that the intradermal vaccination of paternal lymphocytes promoted elevation of BE-Ab1 and BE-Ab2 in sera of the RSA patients,immunization by the IFN-γ in vitro inducing paternal lymphocytes apparently increased level of anti-CD3 blocking antibodies in sera of the RSA patients. The intradermal vaccination of paternal lymphocytes improves pregnant outcome by way of stimulating blocking antibody production,and the immunization with the IFN-γ in vitro inducing paternal lymphocytes contributes to the further pregnant outcome by way of increasing anti-CD3 blocking antibodies.