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Pregnancy Outcome in Human Couples with Idiopathic Recurrent Abortions: The Role(s) of Female Serum, Mixed Lymphocyte Culture Blocking Factors, Potentiating Factors, and Local Uterine Immunity Before and After Paternal Leukocyte Immunization

  • Alan E. Beer
  • Zhu Xiaoyu
  • A. E. Semprini
  • James F. Quebbeman
Part of the Reproductive Biology book series (RBIO)

Abstract

Two hundred-fifty couples with 4.6 ± 2.2 recurrent spontaneous abortions were fully worked up to ensure the absence of medical, genetic, infectious, structural, or a combination of these etiologies known to be associated with recurrent abortion. In addition, all were evaluated immunogenetically. In 67 couples reported here, the female was immunized with paternal leukocytes on two occasions and post-immunization immune response parameters were evaluated. Pregnancy outcome post-immunization can be predicted by analyzing the normal female serum and heat inactivated female serum mixed lymphocyte culture (MLR) blocking factors and potentiating factors with specificity for the male spouse. Women who abort an additional time post-immunization develop leukocytotoxic antibodies with paternal specificity and do not develop MLR blocking factors with specificity for B lymphocytes. Women who deliver a live born child post-immunization develop leukocytotoxic antibodies with less frequency and all develop maternal/anti-paternal specific MLR blocking factors that are not heat inactivatable and are nearly 100% effective in blocking female stimulator/male responder mixed lymphocyte culture reactivity. A subset of women immunized with paternal leukocytes established pregnancies and delivered severely growth retarded infants. In these patients, lymphocytes in the decidua mantling the conceptus were isolated and were found to be cytotoxic and hyperresponsive in MLR to paternal as well as to third party alloantigens.

Keywords

Recurrent Spontaneous Abortion Mixed Lymphocyte Culture Recurrent Abortion Repeat Abortion Fetoplacental Unit 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. 1.
    Beer A.E., Quebbeman J.F., Ayers J.W.T. and Haines, R.F.: Major Histocompatibility Complex Antigens, Maternal and Paternal Immune Responses, and Chronic Habitual Abortions in Humans. Am. J. Obstet. Gynecol. 141: 987, 1981.PubMedGoogle Scholar
  2. 2.
    Beer A.E., Quebbeman J.F., Semprini A.E., Smouse P.E. and Haines R.F.: Recurrent Abortion: Analysis of the Roles of Parental Sharing of Histocompatibility Antigens and Maternal Immunological Responses to Paternal Antigens. Reproductive Immunology, Isojima S. and Billington W.D. (eds), Elsevier Science Publishers, Amsterdam, 1983.Google Scholar
  3. 3.
    Chaouat G., Kolb P.J., and Wegmann T.G.: The Murine Placenta as an Immunological Barrier Between the Mother and the Fetus, Immunological Reviews 75: 31–60, 1984.CrossRefGoogle Scholar
  4. 4.
    Chaouat G: The Riddle of the Fetal Allograft. Ann. Immunol (Inst. Pasteur) 135 D: 301–351, 1984.Google Scholar
  5. 5.
    Chaouat G, Kiger N., Wegmann T.G.: Vaccination Against Spontaneous Abortion in Mice. J. Reprod. Immunol. 5: 389–392, 1983.PubMedCrossRefGoogle Scholar
  6. 6.
    Boyce E.A., Beauchamp G.K. and Yamakazi K.: The Sensory Perception of Genotypic Polymorphism of the Major Histocompatibility Complex and Other Genes: Some Physiological and Pylogenetic Implications. Hum. Immun. 6: 177–183, 1983.CrossRefGoogle Scholar
  7. 8.
    Beer A.E., Quebbeman J.F. and Semprini A.E.: Immunopathological Factors Contributing to Recurrent Spontaneous Abortion In Humans. Edmonds D.K. and Bennett M.J. (eds), Blackwell Scientific Publication, London, 1985, in press.Google Scholar
  8. 9.
    Gill T.J.: Immunogenetics of Spontaneous Abortions in Humans. Transplan. 35: 1–6, 1983.CrossRefGoogle Scholar
  9. 10.
    Bennett D.: The T Locus of the Mouse Cell. 6: 441–454, 1975.Google Scholar
  10. 11.
    Thomas M.L., Harger J.H., Wagener D.K., Rabin B.S., and Gill T.J. III: Sharing and Spontaneous Abortion in Humans. Am. J. Obstet. Gynec, 1985, in press.Google Scholar
  11. 12.
    Palm J.: Association of Maternal Genotype and Excess Heterozygosity for Ag-B Histocompatibility Antigens Among Male Rats. Trans. Proc. 1(1): 82–84, 1969.Google Scholar
  12. 13.
    Palm J.: Maternal-fetal Interactions and Histocompatibility Antigen Polymorphisms. Trans. Proc. 2: 162–173, 1970.Google Scholar
  13. 14.
    Hings I.M. and Billingham R.E.: Splenectomy and Sensitization of Fischer Female Rats Favors Histoincompatibility of R2 Back-cross Progeny. Transplan. Proc. 13: 1253–1255, 1981.Google Scholar
  14. 15.
    Michie D. and Anderson N.F.: A Strong Selective Effect Associated With a Histocompatibility Gene in the Rat. Ann. N.Y. Acad. Sci. 129: 88–93.Google Scholar
  15. 16.
    Clark D.A.: Local Suppressor Cells and the Success or Failure of the Fetal Allograft. Ann. Immunol. (Inst. Pasteur) 135 D: 321–324, 1984.CrossRefGoogle Scholar
  16. 17.
    Beer, A.E.: How Did Your Mother Not Reject You? Ann. Immunol. (Inst. Pasteur) 135 D: 315–318, 1984.CrossRefGoogle Scholar
  17. 18.
    Mclntrye J.A. and Faulk W.P.: Allotypic Trophoblast Lymphocyte Crossreactive (TLX) Cell Surface Antigens. Hum. Immunol. 4: 27, 1982.CrossRefGoogle Scholar
  18. 19.
    Johnson P.M., Barner R.M.R., Risk J.M., Mollay C.M. and Woodrow J.C.: Immunogenetic Studies of Recurrent Spontaneous Abortions in Humans. Expl. Clin. Immunogenet. 2: 77–83, 1985.Google Scholar
  19. 20.
    Beer A.E., Semprini A.E., Xiaoyu Z. and Quebbeman J.F.: Pregnancy Outcome in Human Couples With Recurrent Spontaneous Abortions: 1) HLA Antigen Profiles; 2) HLA Antigen Sharing; 3) Female Serum MLR Blocking Factors; and, 4) Paternal Leukocyte Immunization. Exp. Clin. Immunogenet., 1985a, in press.Google Scholar
  20. 21.
    Taylor C. and Faulk W.P.: Prevention of Recurrent Abortions With Leukocyte Transfusions. Lancet II, 8237: 68, 1981.CrossRefGoogle Scholar
  21. 22.
    Alper C.A., Awdeh Z.L., Roum D.D., Yunis E.J.: Possible Human Analogs of the Murine T/t Complex: Expl. Clin. Immunogenet. 2: 125–136, 1985.Google Scholar

Copyright information

© Plenum Press, New York 1986

Authors and Affiliations

  • Alan E. Beer
    • 1
  • Zhu Xiaoyu
    • 2
  • A. E. Semprini
    • 3
  • James F. Quebbeman
    • 1
  1. 1.Department of Obstetrics and Gynecology L5007-Women’s HospitalUniversity of MichiganAnn ArborUSA
  2. 2.Maternal and Child Health HospitalHubei ProvinceChina
  3. 3.University of MilanoItaly

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