OBJECTIVE: An increased number of NK cells is associated with autoimmune disorder and is known to play a role in infertility. The aim of our research was to monitor the density of NK cells CD56+ and CD16+ in ovulatory cervical mucus (OCM) and in endometrium in infertile women as well as in connection with the actual status of antibodies against phospholipids, sperm and HHV-6 antibodies. TYPE OF STUDY: Original aticle. SETTING: Genetika - Plzeň. METHODS: Seventy-two randomly selected women aged 20-39 (mean age: 32.3) years old resulted in fifty-seven patients with repeated unexplained miscarriages, and fifteen fertile healthy women. The hormonal status was studied including ovulation, the humoral autoimmune responses to eight phospholipids, trombophilia, karyotyping, hysteroscopy, and endometrium immunohistology. Patients were without any clinical and laboratory symptoms of vaginitis at the time of OCM sampling and endometrium study. In one patient antiphospholipid syndrome was present, and in one woman diabetes mellitus was identified. Uterine NK cells CD56+ , CD16+ and NK cells in OCM were identified by immunocytochemistry, antiphospholipid antiboides by ELISA. We used indirect MAR-test for study of local spermagglutinating antibodies in OCM. Indirect immunofluorescent method was used for detection of serum and OCM IgM, IgG antibodies against HHV-6 levels at the time of ovulation. RESULTS: We found both high density of NK cells CD56+ and CD16+ in OCM and in endometrium in only two infertile women with repeated abortions. NK cells in OCM were missing in other samples of patients. The prevalence of high density of NK cells CD56+ in the endometrium was seen in twenty three (40%), NK cells CD16+ in eleven (19%), NK cells 56+ and NK cells 16+ together in eight (14%). Levels of serum and OCM IgG against HHV-6 in all examined patients were not elevated, no cervical sperm antibodies were found. CONCLUSION: We compared density of NK cells CD56+ and CD16+ in OCM and secretory endometrium in all infertile patients. Our results show that cell mucosal activity in the cervical area at the time of ovulation in two infertile patients was evident. We excluded the abnormal number of NK cells owing to local and general viral infection (HHV-6). But our question still remains - are cervical NK cells fixed or still migrating from endometrium into OCM? New research is planned.
- Klíčová slova
- HHV-6, NK cells, endometrium, infertility, ovulatory cervical mucus,
- MeSH
- antigen CD56 imunologie MeSH
- buňky NK imunologie metabolismus MeSH
- CD antigeny krev MeSH
- cervikální hlen fyziologie MeSH
- dospělí MeSH
- endometrium imunologie metabolismus patologie MeSH
- fertilita imunologie MeSH
- habituální potrat krev imunologie MeSH
- lidé MeSH
- mladý dospělý MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- ženská infertilita krev imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antigen CD56 MeSH
- CD antigeny MeSH
INTRODUCTION: This statements follows the first part of our publication entitled Screening of endometrial NK cells in selected infertile patients (First part - Methods and current results), where we dealt with methodology and endometrial findings of the natural killer cells CD16+ and CD56+. These cells are among the most important in preimplantaion, and in implantation period, in early pregnancy too, but can also negatively influence above mentioned processes. OBJECTIVE: We focused on the immunomodulatory treatment with intramuscular immunoglobulins in 21 infertile patients with a high density of endometrial NK cells CD16+ and CD56+. DESIGN: Original work-prospective study. SETTING: Genetics-Pilsen. METHODS: From the originally investigated 57 women aged 25-41 (average 34) years with their history of 3-9 abortions, we target on a high selective subgroup of 21 infertile patients with pathological density of endometrial NK cells CD56+ and CD16+. RESULTS: Twelve patients underwent immunomodulatory treatment with intramuscular immunoglobulin in time of positive HCG and went on the therapeutic scheme, nine infertile women continued with IVF-ET but did not achieve HCG positivity despite of initial treatment with immunoglobulins. Of the 12 treated patients, seven of them gave a birth to healthy babies, as to the next five pregnancies - one was extrauterine pregnancy, one genetically defective fetus, three pregnancies go on successfully.Nine women from the IVF program did not get pregnat. CONCLUSION: Immunomodulatory treatment with immunoglobulins also influences endometrial NK cells CD56+ and CD16+ associating with an overproduction of embryocytoxic cytokines. Treatment of our patients with the pathological endometrial density of NK cells must be solved strictly individually.
- Klíčová slova
- immunoglobulins, infertility, natural killer cells endometrium., treatment,
- MeSH
- antigen CD56 imunologie MeSH
- buňky NK imunologie MeSH
- choriogonadotropin MeSH
- dospělí MeSH
- endometrium patologie MeSH
- fertilizace in vitro * MeSH
- imunomodulace * MeSH
- lidé MeSH
- receptory IgG imunologie MeSH
- těhotenství MeSH
- ženská infertilita farmakoterapie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- antigen CD56 MeSH
- choriogonadotropin MeSH
- receptory IgG MeSH
INTRODUCTION: Generaly, natural killer cells (NK cells) are among the most important cells of our immune defense system. They are present in the blood, decidua but also in secretory endometrium. OBJECTIVE: We investigate an association between high density of NK cells CD56+ and NK cells CD16+ into blood and secretory endometrium in patients with up to now unexplained recurrent miscarriage. At the same time, we focused on diagnosis of antiphospholipid syndrome, congenital trombophilic factors, stress factor, and lenght of hormonal contraception before conception. DESIGN: Original work-prospective study. SETTING: Genetics-Pilsen. METHODS: We investigated 59 patients aged 25-41 (average 34) years with their history of 3-9 abortions. We monitored their blood cells by flow cytometry and endometrium obtained by hysteroscopy performed on the 22nd-24th day of the menstrual cycle. We concentrated on the cellular immunity focused on the identification of lymphocytes CD56+ and CD16+. ELISA method was used for identification of antiphospholipid antibodies. RESULTS: Our study goes on, we are publishing our preliminary results. We found a high density of endometrial NK cells CD56+ in 41/57, NK cells CD16+ in 40/57, both NK cells CD56+ and CD16+ in 36/57 patients. In 13 women, we identified only sporadically these cells in the secretory endometrium. NK cells CD56+ and NK cells CD16+ in the blood were all normal number in all our patients. Three of them have a homozygot form of Leiden mutation, and 18/57 primary antiphospholipid syndrome, 12 women have university education, four of them, medical doctors, have regular night services in the hospital. CONCLUSION: Overproduction of endometrial NK cells is associated with increased local activity of embryocytotoxic cytokines that may negatively affect pregnancy. Treatment of patients with pathological immunological findings must be solved individually, as we will show soon in part two of our study.
- Klíčová slova
- infertility, natural killer cells endometrium.,
- MeSH
- buňky NK imunologie metabolismus MeSH
- dospělí MeSH
- endometrium imunologie metabolismus patologie MeSH
- habituální potrat krev imunologie patologie MeSH
- lidé MeSH
- prospektivní studie MeSH
- těhotenství MeSH
- ženská infertilita krev imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Purpose: Increased levels of antiphosholipid antibodies (aPLs) are associated with the autoimmune disorder antiphospholipid syndrome (APS) and are known to play a role in infertility. We investigated the possible effect of prolonged use of hormonal contraception (HC) on autoimmunity after discontinuing HC in women with infertility problems. Material and Methods: We analyzed hormonal status including ovulation and the humoral autoimmune response to eight phospholipids detected by ELISA in 1190 infertile women aged 21-46 (mean age: 29.3) years. Results: Long-term HC did not affect ovulation, but in the absence of ovulation HC masked the hormonal disorders. The majority of patients taking HC for more than 10 years with fertility failure had significantly higher levels of aPLs of the IgG isotype against phosphatidylinositol and phosphatidylserine (p > 0.001) than against β2-glycoprotein I and annexin V. Discussion: Thus, high levels of aPLs are significant for the anticoagulant treatment before and during pregnancy to prevent pregnancy loss.
Zielsetzung: Das erhöhte Auftreten von Antiphospholipid-Antikörpern im Blut ist mit der Autoimmunerkrankung Antiphospholipid-Syndrom (APS) assoziiert und spielt bekanntlich eine Rolle bei Infertilität. In Frauen mit Fertilitätsproblemen wurde die mögliche Auswirkung der Langzeiteinnahme hormoneller Empfängnisverhütungsmittel auf die Autoimmunität untersucht, die auch nach Absetzen des Mittels fortbesteht. Methoden: In 1190 unfruchtbaren Frauen im Alter von 21–46 (Durchschnittsalter: 29,3) Jahren wurden Hormonstatus und Eisprung sowie die durch ELISA ermittelte humorale Immunreaktion auf 8 Phospholipide untersucht. Ergebnisse: Die Langzeiteinnahme hormoneller Empfängnisverhütungsmittel hatte keine Auswirkung auf den Eisprung, aber bei Ausbleiben des Eisprungs hat die hormonelle Empfängnisverhütung die Hormonstörung überdeckt. Die Mehrheit der Patientinnen mit Fertilitätsproblemen, die Hormonpräparate zur Empfängnisverhütung über einen Zeitraum von mehr als 10 Jahren einnahmen, wiesen signifikant höhere Antiphospholipid-Antikörper-Spiegel des IgG-Isotyps gegen Phosphatidylinositol und Phosphatidylserin (p > 0,001) auf als gegen β2-Glykoprotein I und Annexin V. Diskussion: Hohe Antiphospholipid-Antikörper-Spiegel erweisen sich also als signifikant für die antikoagulatorische Therapie vor und während der Schwangerschaft, um einem frühzeitigen Ende der Schwangerschaft vorzubeugen.
- Klíčová slova
- antiphospholipid antibodies, antiphospholipid syndrome, hormonal contraception, infertility,
- Publikační typ
- časopisecké články MeSH
OBJECTIVE: To determine whether patients with recurrent spontaneous abortions and IVF suffer from latent celiac disease. DESIGN: Perspective study. SETTINGS: Department of Gynecology and Obstetrics and Faculty Hospital, Charles University, Pilsen. MATERIAL AND METHODS: Sera from 442 infertile patients aged 23-47 years and 86 healthy fertile controls aged 22-38 years were examined by commercial ELISA sets for the presence (absence) of antibodies against gliadin IgG, IgA and tissue transglutaminase in IgG and IgA. RESULTS: We found a statistically significant difference between the control group and patients with decreased fertility. They have a positive values in anti-tissue transglutaminase IgA (p = 0.0096). Frequent, very low positive reaction of antigliadin IgG was also found in the control group of women. CONCLUSION: Patients with unexplained repeated miscarriages and repeated unsuccessful IVF with IgA positive tissue transglutaminase have new complement of other tests for autoimmunity and examination of a total IgA, and gastroenterological examination. Eleven patients with significant positive anti-tissue transglutaminase IgA were successfully conceived only under strict gluten-free diet.
- MeSH
- celiakie komplikace epidemiologie MeSH
- dospělí MeSH
- habituální potrat epidemiologie MeSH
- incidence MeSH
- lidé MeSH
- mladý dospělý MeSH
- studie případů a kontrol MeSH
- ženská infertilita komplikace epidemiologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
Autoimmune diseases can be accompanied by presence of various antiphospholipid antibodies (aPL). The laboratory criteria of antiphospholipid syndrome are based on detection of anticardiolipin, lupus anticoagulant or to antiβ2- glycoprotein I but currently a significance of other multiple aPL is being discussed. Because of their vascular and neuroinflammatory effect aPL, if being transplacentally transferred, might inflict damage in developing organism. The aim of our study was to determine the occurrence of eight selected aPL in offspring of mothers with proven autoimmune disease with aPL positivity. The possible influence of aPL presence on clinical, ultrasound and laboratory outcome of children was observed as well. The prospective study included 38 women: 17 women with primary antiphospholipid syndrome and 21 women with other diagnosed autoimmune disease with detected aPL. Also included were 39 children born to the above mentioned mothers between January 2009 and April 2010 in Perinatology Centre in Pilsen, Czech Republic. The control group consisted of 30 mothers without AD and their 30 healthy singletons. Preliminary results of the study showed the presence of aPL in 42.1% neonates of aPL positive mothers with autoimmune disease, six month later aPL were present in only 37.5 % of these children. Observed occurrence of aPL positivity at 6 months of age in originally negative offspring could be attributed to vaccination or food exposure. Psychomotor development of children has proceeded without major deviations. The follow-up study continues and will evaluate both groups of children at two years of age.
- MeSH
- antifosfolipidové protilátky krev MeSH
- autoimunitní nemoci krev imunologie MeSH
- dospělí MeSH
- kojenec MeSH
- komplikace těhotenství krev imunologie MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec krev imunologie MeSH
- prospektivní studie MeSH
- studie případů a kontrol MeSH
- těhotenství MeSH
- vývoj dítěte MeSH
- zdravotní stav MeSH
- Check Tag
- dospělí MeSH
- kojenec MeSH
- lidé MeSH
- mladý dospělý MeSH
- novorozenec krev imunologie MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antifosfolipidové protilátky MeSH
OBJECTIVE: The aim of our preliminary study was to compare the levels of total local sIgA and IgG with activity of detected sperm antibodies in ovulatory cervical mucus (OCM). SETTING: Department of Gyneacology and Obstetrics, Medical School and Faculty Hospital, Charles University, Plzen. METHODS: We screened samples of OCM from 12 pacients aged 26-31 (29,6 years on average) by radial immunodifusion (RID) to determine s IgA and IgG. Indirect MAR test was used for detection of spermagglutinationg antibodies. RESULTS: We found out by RID the average concentration of sIgA in OCM 567,84 mg/l (0 -1250,47) and the average concentration of IgG in OCM 23,57 mg/l (8,74-47,99). Antibody activity against sperm cells dominates in IgA with 6 pacients, in IgA with 1 patient, in IgA and IgG together with 1 infertile woman and in IgA and IgM isotypes together with 1 patient. No local sperm antibodies were determined with 3 patients. CONCLUSION: We proved the hypothesis, that the levels of spermagglutinating antibodies do not correlate with findings of total sIgA and IgG in OCM with our patients.
- MeSH
- aglutinace spermií imunologie MeSH
- cervikální hlen imunologie MeSH
- dospělí MeSH
- imunoglobulin A sekreční analýza MeSH
- imunoglobulin G analýza MeSH
- lidé MeSH
- mladý dospělý MeSH
- ovulace * MeSH
- protilátky analýza MeSH
- spermie imunologie MeSH
- ženská infertilita imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- imunoglobulin A sekreční MeSH
- imunoglobulin G MeSH
- protilátky MeSH
The objective of our study was to evaluate the significance of extended antiphospholipid profile in patients with venous thromboembolism without any systemic autoimmune disease. In 140 patients (age 18-69 years; 47.1% men) with venous thromboembolism and 136 control participants we tested anticardiolipin antibodies, anti-beta 2 glycoprotein I (anti-beta2-GPI) and also non-criteria antiphospholipid antibodies: antiphosphatidic acid, antiphosphatidylethanolamine, antiphosphatidylglycerol, antiphosphatidylinositol, antiphosphatidylserine. Commercial and in-house enzyme-linked immunosorbent assays were used. The antibodies with significantly higher prevalence in patients (compared to controls) were: immunoglobulin (Ig) M-anticardiolipin antibodies (12.9%; P = 0.035), IgG-anti-beta2-GPI (16.4%; P = 0.0032), IgM-antiphosphatidylethanolamine (14.3%; P = 0.014). In most cases, these three antibodies did not overlap. In conclusion, of non-criteria antiphospholipid antibodies, only antiphosphatidylethanolamine were significantly more prevalent in patients with venous thromboembolism, with only minor overlapping with the criteria antiphospholipid antibodies. Our results suggest the possible utility of searching for antiphosphatidylethanolamine in the clinical suspicion of antiphospholipid syndrome and the absence of criteria antiphospholipid antibodies.
- MeSH
- antifosfolipidové protilátky krev MeSH
- antifosfolipidový syndrom krev imunologie MeSH
- antikardiolipinové protilátky krev MeSH
- autoantigeny imunologie MeSH
- beta-2-glykoprotein I imunologie MeSH
- dospělí MeSH
- fosfatidylethanolaminy imunologie MeSH
- fosfolipidy imunologie MeSH
- imunoglobulin G krev imunologie MeSH
- imunoglobulin M krev imunologie MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- senioři MeSH
- specificita protilátek MeSH
- trombofilie krev genetika imunologie MeSH
- žilní tromboembolie krev etiologie imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mladiství MeSH
- mladý dospělý MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Názvy látek
- antifosfolipidové protilátky MeSH
- antikardiolipinové protilátky MeSH
- autoantigeny MeSH
- beta-2-glykoprotein I MeSH
- fosfatidylethanolaminy MeSH
- fosfolipidy MeSH
- imunoglobulin G MeSH
- imunoglobulin M MeSH
OBJECTIVE: Isolation of spermagglutinating antibodies and their assesment. DESIGN: Retrospective study. SETTING: Special consulting for reptoduction immunology, Department of Obstetrics and Gynecology, Charles University and Faculty Hospital, Plzen. METHODS: Fractionation of serum samples by liquid exclusion chromatography, examination of full sera and their chromatographic fractions by Friberg teste (Tray Agglutination Test--TAT), indirect antiimmunoglobulin reaction test (i-MAR test) and by supplementar radial immunodiffusiona (RID). RESULTS: Isolation of spermagglutinating fractions of antisperm antibodies positive sera preserved spermagglutinating aktivity and confirmed great spermagglutinating potential of IgM. CONCLUSION: According to assesment of the presence of IgG and IgG we reported possible states of immunisation: actual immunisation with IgM activity, perpetual stimulation (IgG and IgM) and, finaly, anamnestic titres in IgG. These findings can help us to choose an optimal way of treatment. Excluding gel chromatography is suitable method for serum proteins fractionation, but not their identification--presence of antisperm antibodies does not affect the chromatographic spectrum, nor the RID patterns.
- MeSH
- aglutinace spermií imunologie MeSH
- aglutinační testy MeSH
- autoprotilátky analýza imunologie MeSH
- infertilita imunologie MeSH
- lidé MeSH
- spermie imunologie MeSH
- Check Tag
- lidé MeSH
- mužské pohlaví MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- autoprotilátky MeSH
OBJECTIVE: To study of IgG antibodies against laminin-1 (IgG-a-Ln-1) in patients with decreased fertility, especially with endometriosis and with diagnosis of polycystic ovaries. DESIGN: Prospective study. SETTING: Special Consultation for Immunology of Reproduction and Research Laboratories for Reproductive Immunology, Department of Gynaecology and Obstetrics, Medical School of Charles University and Faculty Hospital, Pilsen. METHODS: Commercial ELISA kits for detection of IgG antibodies against laminin-1 in serum (S) and peritoneal fluid (PF) in 120 patients after diagnostic laparoscopy, and in serum in 277 patients after 2-3 in vitro fertilizations and with diagnosed endometriosis. RESULTS: Only 16 positive results in IgG-a-Ln-1 antibodies (more than 15 IU/ml) were detected in sera and peritoneal fluids in the group of 120 women after laparoscopy. We have not detected any serum IgG-a-Ln-1 positivity in the group of 277 patients after 2-3 unsuccesfull IVF and with anamnestical date about endometriosis together. CONCLUSION: Increased levels of IgG-a-Ln are in particular found in endometriosis II-III and in diagnosis of polycystic ovaries, in female diseases also related to autoimmune process.
- MeSH
- ascitická tekutina chemie MeSH
- autoprotilátky analýza MeSH
- dospělí MeSH
- endometrióza komplikace imunologie MeSH
- imunoglobulin G analýza MeSH
- laminin imunologie MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženská infertilita krev etiologie imunologie MeSH
- Check Tag
- dospělí MeSH
- lidé MeSH
- mladý dospělý MeSH
- těhotenství MeSH
- ženské pohlaví MeSH
- Publikační typ
- anglický abstrakt MeSH
- časopisecké články MeSH
- Názvy látek
- autoprotilátky MeSH
- imunoglobulin G MeSH
- laminin 1 MeSH Prohlížeč
- laminin MeSH
