| PrefaceSpontaneous abortion is one of the most common complications of pregnancy , but the etiology of a significant proportion of abortion is still unknown. The immune system is thought to play an important role , excluding chromosomal a-nomalies,endocrinologic abnormalities , infectious etiologies , anatomic problems et al. The human conceptus is a semiallograft and hence antigenically foreign to the mother . Successful human reproduction is dependent on the balance of maternal - fetal immunology , which is characterized by a lack of strong maternal cell-mediated anti - fetal immunity and a dominant humoral immune response . Once the balance of maternal-fetal immunology shifted, the human conceptus should be rejected ,thus lead to abortion. It has been wildly accepted that Th1 type cytokines ( IL-2 , TNF- , IFN- et al) are harmful to pregnancy and can lead to fetal death, whereas Th2 type cytokines (IL-4,IL-5,JL-6 et al) are beneficial . Studies have showed that successful pregnancy occurs in a Th2 - dominant situation and that Th,-type immunity is associated with pregnancy failure . The balance of Th1/Th2 is effected by many factors ,if we can find a factor which is closely correlated with the balance , thus will help us to find the mechanism of spontaneous abortion.IAP is an immunosuppressive factor , which increased significantly in cancer patients and renal transplant patients with rejection . Haruo seki reported that serum IAP levels increased slightly in normal early pregnant women . This study showed that serum IAP levels and ratios of Th1/Th2 increased significantly in patients with fetal death in early pregnancy compared with normal early pregnant women and IAP levels were closely correlated with ratios of Th1/Th2, these results suggest that increased serum IAP have some effects on the regulation of ma-ternal - fetal immunology.Materials and MethodsPatients:The following groups were studied:1. group 1 comprised 26 patients with fetal death in early pregnancy, excluding chromosomal anomalies ,endocrinologic abnormalities ,infectious etiologies, anatomic problems.2. group 2 comprised 20 early normal pregnant women without a history of spontaneous abortion , still birth and fetal death.3. group 3 comprised 20 health non - pregnant volunteers without a history of spontaneous abortion ,still birth and fetal death.Methods:1. Th1(TNF-3) ,Th2(IL-4)cytokine levels were measured by ELISA kits.2. IAP levels were measured by single radial immunodiffusion kits. . Statistic:All the data were analyzed by SPSS [11.5], Results were expressed as means å¤ SD, results were analyzed by t-test and correlation.ResultsSerum 1AP levels were higher significantly in patients with fetal death in early pregnancy compared with normal early pregnant women, whereas in normal early pregnant women, levels were slightly raised compared with health non-pregnant women. In patients with fetal death in early pregnancy, IL-4 levels were slightly reduced and TNF-p were raised slightly compared with normal early pregnant women, whereas ratios of TNF-p/ IL-4 were higher significantly. In patients with fetal death in early pregnancy IAP levels were closely correlated with ratios of TNF-p/ IL-4.DiscussionIAP has a molecular weight of 50000, an isoelectric point of 3. 0, a darbo-hydrate 31.5%. The protein is produced by macrophages and granulocytes et al. It has been suggested that it might play a role in the impairment of the immuno-logical surveillance mechanism. In this study, the levels of IAP in patients with fetal death were higher signiflcandy than those of early normal pregnancy women. This result suggested that serum IAP were involved in the modulation of maternal - fetal immunology, when levels of IAP increased signiflcandy, it can lead to fetal death.Th1,Th2 cell are the major subsets of fully differentiated Th cells. Th1 cells generally mediate cell - mediated reactions via the production of Th1 - type cyto-kines IL - 2 , IFN- , TNF-, while Th2 cells encourage antibody produ... |
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