Intravenous immunoglobulin (IVIG) treatment modulates peripheral blood Th17 and regulatory T cells in recurrent miscarriage patients: Non randomized, open-label clinical trial

Immunol Lett. 2017 Dec:192:12-19. doi: 10.1016/j.imlet.2017.10.003. Epub 2017 Oct 10.

Abstract

Background: Th17 cells and Treg cells have been proposed as new risk factors for recurrent miscarriage (RM). In this study, we investigated the effect of Intravenous immunoglobulin G (IVIG) on the levels and function of Th17 and Treg cells and pregnancy outcome in women with RM.

Materials and methods: 94 pregnant women with RM were enrolled in this study. Blood was drawn at the time of positive pregnancy. On the same day, IVIG 400mg/kg was administered intravenously for 44 patients. 50 other RM patients were included as no IVIG interfering control group. Following the first administration, IVIG was given every 4 weeks through 32 weeks of gestation. Peripheral blood was drawn after the last administration (32 weeks after pregnancy).

Results: IVIG down-regulated Th17 cells population and function and up-regulated Treg cells population and function were significant in the treated group. Pregnancy outcome in IVIG treated subjects was successful in 38 out of 44 RM women (86.3%). However, pregnancy outcome was successful in 21 out of 50 untreated RM women (42%).

Conclusion: Administration of IVIG in RM women with cellular immune cells abnormalities during pregnancy influences Th17/Treg ratio in peripheral blood and enhances Treg and decreases Th17 responses.

Keywords: Intravenous immunoglobulin G; Recurrent miscarriage; Th17; Treg.

Publication types

  • Clinical Trial
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Abortion, Habitual / immunology
  • Abortion, Habitual / therapy*
  • Adult
  • Blood Cells / immunology*
  • Cytokines / genetics
  • Cytokines / metabolism
  • Female
  • Forkhead Transcription Factors / genetics
  • Forkhead Transcription Factors / metabolism
  • Gene Expression Regulation
  • Humans
  • Immunoglobulins, Intravenous / therapeutic use*
  • Immunotherapy / methods*
  • Pregnancy
  • Pregnancy Outcome
  • T-Lymphocytes, Regulatory / immunology*
  • Th17 Cells / immunology*

Substances

  • Cytokines
  • FOXP3 protein, human
  • Forkhead Transcription Factors
  • Immunoglobulins, Intravenous