Autoinmunidad en pacientes con pérdida recurrente del embarazo
DOI:
https://doi.org/10.18597/rcog.796Palabras clave:
Autoanticuerpos, abortadora primaria, fosfolípido, PRE pérdida recurrente del embarazoResumen
Un grupo de 90 mujeres con antecedente de 2 o más abortos espontáneos de causa desconocida, sin historia de partos anteriores, con estudio inmunológico que determinó ausencia de respuesta aloinmune y un grupo de control de 31 mujeres con antecedentede fertilidad comprobada, se estudiaron para anticuerpos a antígenos nucleares, anticoagulante lúpico y fosfolípidos. Demostramos serológicamente un incremento en la respuesta autoinmune a partir del segundo aborto. Los anticuerpos antifosfolípidos y los anticuerpos antinucleares aparecen presentes ya como epifenómenos ya como factores etiológicos en pacientes con pérdida recurrente del embarazo PRE.
La importancia de los hallazgos mencionados y la novedad del presente traba,jo consiste en la identificación del incremento en la respuesta autoinmune a partir del segundo aborto.
Biografía del autor/a
Francisco J. Espinel
MD Coordinador Unidad lnmunobiología y Genética.
Julio C. Mendoza
Instructor Asistente Colegio Mayor del Rosario.
Jeannette Cubillos
Bacterióloga Coordinadora Laboratorio Unidad lnmunobiología y Genética.
Emilce Botero
Referencias bibliográficas
Coulam C., Faulk P., Mclntyre JA., Critser JK. Pregnancy outcome after diagnosis of recurrent spontaneous abortion. In: Mettler L, Billington WD, eds. Reproductive Inmunology 1989. Amsterdam: Elsevier Science Publishers 1990; 195-202.
Ober C., Elias S. The role of HLA-Dr in reproduction: results of prospective, population-based studies in U.S. Hutterites In: Mettler L, Billington WD, eds. Reproductive Inmunology 1989. Amsterdam: Elsevier Science Publishers 1990; 203-210.
Mowbray JF., Underwood JL. Inmunization with paternal cells in treatment of very early recurrent abortion. In: Mettler 1; Billington WD, eds. Reproductive Inmunology 1989. Amsterdam: Elsevier Science Publishers 1990; 211-216.
Rote NS, NG AK., Ault KA., Carmody M., Dostal-Johnson DA., MitchellJ,NG S., Roberts R., Siekman R. Antiphospholipid antibodies and recurrent pregnancy loss: Analysis of monoclonal and polyclonal antiphosphatidylserine antibodies. In: Mettler L, Billington WD, eds. Reproductive Inmunology 1989. Amsterdam: Elsevier Science Publishers 1990; 217-226.
Beer AE. Inmunologic aspects of normal pregnancy and recurrent spontaneous abortion. Semin. Reprod. Endo. 1988; 6: 163-180.
Beer AE., Quebbeman JF., Ayers JWT., Haines RF. Major histocompatibility complex antigens, maternal and paternal inmune responses, and chronic habitual abortions in human. Am. J. Obstet. Gynecol. 1981; 141 : 987-999.
Sibai BM., Mirro R., Chesney CM., Leffler C. Low dose aspirin in pregnancy. Obstet. Gynecol. 1898; 74: 551-557.
Mclntyre JA., Faulk WP., Nichols.-Johnson VR., Taylor CG. Inmunologic testing and inmunotherapy in recurrent spontaneous abortion. Obstet. Gynecol. 1986; 67: 169.
Beer AE. New horizons in the diagnosis, evaluation and therapy of recurrent spontaneous abortion. Clin. Obstet. Gynecol. 1986; 13: 115- 122.
Ho H-N., Gill TJ., Nsieh R-P., Hsieh H-J., Lee T-Y. Sharing of human leukocyte antigens in primary and secondary recurrent spontaneous abortions. Am. J. Obstet. Gynecoll990; 163: 178-188.
BranchDW.,AndresR., DigreKB., RoteNS., ScottJR. Theassociation of antiphospholipid antibodies with severe preeclampsia. Obstet. Gynecol. 1989; 73: 541-545.
Chavez D., Mclntyre JA., Colliver JA., Faulk WP. Allogeneic matings and inmunization have diferenteffects on nu11iparous and multiparous mice. J. Inmunol. 1987; 139: 85-88.
Redman CWG. Inmunology of the placenta. Clin. Obstet. Gynecol. 1986; 13: 469-499.
Billington RE. From transplantation biology to reproductive inmunobiology. Obstet. Gynecol. 1978; 7: 1-14.
Kovats S., Main EK., Librach C., Stubblebine M., Fisher S., DeMars R. A class 1 antigen, HLA-G, expressed in Human trophoblasts. Science 1990; 248: 220-223.
Infante-Rivard C., David M., Gauthier R., Rivard G. Lupus anticoagulants, anticardiolipin antibodies, and fetalloss. N. Engl. J. Med. 1991; 325: 1063-1066.
KwakJYH., Beer AE. Reproductive outcomein women with recurrent spontaneous abortions of alloinmune and autoinmune etiologies; pre vs post conceptional treatment. Dept. of Ob/Gyn, UHS/Chicago Medical School, North Chicago, IL 60064.
KwakJYH.,Gilman-SachsA.,BeamanKD.,BeerAE.Autoantibodies in women with primary recurrent spontaneous abortion (RSA) of alloinmune etiology. Dept of Ob/Gyn, UHS/Chicago Medical School, North Chicago, IL 60064.
Barini, KwakJ, Polgar K., HillJA., Beer AE. The embryotoxic factor assay in women with recurrent pregnancy loss and subsequent pregnancy outcome. Dept. of Ob/Gyn, UHS/Chicago Medical School, North Chicago, IL 60064 and Harvard Medical School, Boston, MA 02115.
Salafia C., Barini R., Vogel C., Kwak J., Beer AE. Placental inmunopathology in live born infants of women with recurrent spontaneous abortions (RSA) of alloinmune etiology inmunized with paternal limphocytes. Dept. of Ob/Gyn, UHS/Chicago Medica! School, North Chicago, IL 60064 and Danbury Hospital, Danbury CT.
Kwak J., Ober C., Barini R., Beer AE. Maternal autoinmune abnormalities and fetal HLA-DQA1 alleles in women with recurrent spontaneous abortion (RSA). Dept .. ofOb/Gyn, UHS/Chicago Medical School, North Chicago, IL 60064.
Gurka G., Rocklin R. Reproductive Inmunology. JAMA 1987;258: 2983-2987.
Hanson LA., Carlsson B., Ekre HP., Hahn-Zoric M., Osterhaus AD., Roberton D. Inmunoregulation mother fetus/newborn, a role for antiidiotypic antibodies. Acta Pediatr Scand 1989; 351: 38-41.
Crainie M., Stimson WH. The maternal inmune response to a new human trophoblastantigen. J. Clin. Lab. Inmunol. 1988; 27: 103-107.
Claman HN. The biology ofthe inmune response. JAMA 1987; 258: 2834-2840.
Scott Jr., Rote NS., Branch DW. Inmunologic aspects of recurrent abortion and fetal death. Obstet. Gynecol 1987; 70: 645-656.
Clark D., Daya S. Inmunotherapy for unexplaneid recurrent abortion; problems in proving efficacy/inefficacy. Am. J. Reprod. Inmunol. 1991; 25: 49.
Ho H-N., Gill TJ., Hsieh C-Y, Lee T-Y. Inmunotherapy for recurrent spontaneous abortions in a chinese population. Am. J. Reprod. Inmunol. 1991; 25: 49.
Johnson P., Ramsden G. A combined randomized double blind and open study of trophoblast membrane infusion (TMI) in unexplained recurrent abortion. Am. J. Reprod. Inmunol 1991; 25: 50.
HuetzF., JacquemartF.,PeñaC., VarelaF., Coutinho A. Autoinmunity: the moving boundaries between physiology and pathology. In Bach JF eds. Inmunointervention in autoinmune diseases . London: Academic Press Limited 1989; 11-22.
Hill J. , Polgar K., Harlow B., Anderson D. Evidence of embryo and trophoblast-toxic cellular irnrnune response(s) in women with recurrent spontaneous abortion. Am. J. Obstet. Gynecol. 1992; 166: 1044-
Ladines C., Maruo T., Manalo A., Mochizuki M. Cytologic localization of epidermal growth factor and its receptor in developing human placenta varies over the course of pregnancy. Am. J. Obstet. Gynecol. 1991; 165: 1377-1382.
Hansen K., OpsahiM.,NiemanL., Baker J., Klein T. Naturalkillercell activity from pregnant subjects is modulated by RU 486. Am. J. Obstet. Gynecol 1992; 166: 87-90.
Silver R. , Adler L., Hickman, Hageman J. Anticardiolipin antibody positive serum enhances endothelial cell platelet activating factor production. Am. J. Obstet. Gynecol. 1991; 165: 1748-1752.
Feinberg B., Tan N., Gonik B., Brath P. , Walsh S. Increased progesterone concentrations are necesary to suppress interleukin 2 activated human mononuclear cell cytotocity. Am. J. Obstet. Gynecol. 1991; 165: 1872-1875.
Cómo citar
Descargas
Descargas
Publicado
Número
Sección
Licencia
Derechos de autor 2016 Revista Colombiana de Obstetricia y Ginecología
Esta obra está bajo una licencia internacional Creative Commons Atribución-NoComercial-SinDerivadas 4.0.
| Estadísticas de artículo | |
|---|---|
| Vistas de resúmenes | |
| Vistas de PDF | |
| Descargas de PDF | |
| Vistas de HTML | |
| Otras vistas | |
