Time course of changes in the subpopulation composition of peripheral blood lymphocytes in the pregravid preparation of women with recurrent miscarriage

Krechetova L.V., Vtorushina V.V., Golubeva E.L., SaribegovaV.A., Khachatryan N.A., Agadzhanova A.A., Tetruashvili N.K.

Research Center of Obstetrics, Gynecology, and Perinatology, Ministry of Health of Russia, Moscow 117997, Ac. Oparina str. 4, Russia
Pregravid preparation that may encompass both immunocytotherapy (ICT) and medical treatments (with gestagens) occupies a special place in the therapy of idiopathic recurrent abortion.
Objective. To investigate the time course of changes in the subpopulation composition of peripheral blood lymphocytes after various options of immunomodulatory therapy during pregravid preparation of women with recurrent miscarriage of alloimmune genesis.
Subjects and methods. A study group consisted of 51 women with an established diagnosis of recurrent miscarriage of unclear (alloimmune) genesis. A control group comprised 15 fertile women. Pregravid preparation of the women was done by three schemes: ICT with allogeneic cells from partners, ICT together with dydrogesterone, or medical treatment with dydrogesterone. The content of the main subpopulations of immunocompetent T cells (СD3+, CD4+, CD8+), B cells (CD19+), B1 cells (CD19+CD5+), NK cells (СD56+, СD16+), as well as Treg (CD4+CD25highCD127low/-).
Results. After ICT, there was a significant increase in the subpopulation of lymphocytes with the CD5+CD19+ phenotype compared to the control and no changes in the level of the other subpopulations; in the ICT + dydrogesterone group, the concentration of subpopulations with the CD56,16+, CD56+, and CD3+CD56,16+ phenotypes significantly exceeded that in the control group; and the content of Treg remained unchanged. After two dydrogesterone treatment cycles, the levels of Treg, CD200+, CD19+, CD5+19+, CD3+8+, CD3+CD56,16+ cells remained unchanged; but there was a considerable increase in the concentrations of CD3-CD8+, CD3-CD16+, CD16+, CD56+, CD3-CD56,16+, and CD56,16+ subpopulations and a substantial decrease in CD3+, CD3+CD4+ ones.
Conclusion. Each of therapeutic options has a certain immunomodulatory effect, the clinical significance of which remains to be estimated in further investigations conducted during pregnancy.

Keywords

recurrent miscarriage
alloimmune genesis
pregravid preparation
immunocytotherapy
dydrogesterone
gestagens
peripheral blood lymphocyte phenotype
CD200
regulatory T cells

Supplementary Materials

  1. Table 1. The content of lymphocytes of various phenotypes in the peripheral blood of women with a habitual miscarriage outside pregnancy before the appointment of treatment by different schemes in pregestational preparation (M ± m)
  2. Table 2. The content of lymphocytes of various phenotypes in peripheral blood of women with a habitual miscarriage at the end of pre-gestational training, conducted according to different schemes (M ± m)
  3. Fig. 1. Comparative characteristics of the content of subpopulations of peripheral blood lymphocytes in patients with a habitual miscarriage after pregestational preparation
  4. Fig. 2. Characteristics of the content of subpopulations of peripheral blood lymphocytes in patients with a habitual miscarriage during pre-gestational training in comparison with a group of fertile women

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Received 25.04.2017

Accepted 28.04.2017

About the Authors

Krechetova Lyubov V., Ph.D. in medical sciences, Head of Laboratory of Clinical Immunology, Research center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: k_l_v_@mail.ru
Vtorushina Valentina V., Ph.D. in medical sciences, doctor of laboratory diagnostics in Laboratory of Clinical Immunology, Research center of Obstetrics,
Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: vtorushina@inbox.ru
Golubeva Elena L., Ph.D. in medical sciences, doctor of laboratory diagnostics in Laboratory of Clinical Immunology, Research center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: e_golubeva@oparina4.ru
Khachatryan Nelly A., Graduate student, Department of Pregnancy Loss Prevention and Therapy, Research center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381477. E-mail: nelly1986@mail.ru.
Saribegova Victoria A., Graduate student, Department of Pregnancy Loss Prevention and Therapy, Research center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381477. E-mail: saribegova_v@rambler.ru
Agadzanova Anna, Doctor of Medicine, Department of Pregnancy Loss Prevention and Therapy, Research center of Obstetrics, Gynecology and Perinatology,
Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381477. E-mail: aagadjanova@mail.ru
Tetruashvili Nana K., Doctor of Medicine, Head of the Department of Pregnancy Loss Prevention and Therapy, Research center of Obstetrics, Gynecology and Perinatology, Ministry of Health of Russia. 117997, Russia, Moscow, Ac. Oparina str. 4. Tel.: +74954381183. E-mail: tetrauly@mail.ru

For citations: Krechetova L.V., Vtorushina V.V., Golubeva E.L.,
Saribegova V.A., Khachatryan N.A., Agadzhanova A.A., Tetruashvili N.K. Time course
of changes in the subpopulation composition of peripheral blood lymphocytes
in the pregravid preparation of women with recurrent miscarriage.
Akusherstvo i Ginekologiya/Obstetrics and Gynecology. 2017; (6): 55-63. (in Russian)
http://dx.doi.org/10.18565/aig.2017.6.55-63

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