[Influences of active immunotherapy on T helper cell type 1 and 2 cytokines in women with unexplained habitual abortion].

OBJECTIVE: To investigate the influences of active immunotherapy on T helper cell (Th)1/Th2 type cytokines in women with unexplained habitual abortion (UHA).

METHODS: A total of 55 patients with UHA were studied, including 30 cases after active immunotherapy (AIT) and 25 cases without any therapy (NAIT). Fifteen cases of normal nonpregnant (NNP) women were selected as control group. Supernatants from trophoblast-activated peripheral blood mononuclear cells (PBMC) of the three groups were tested by enzyme-linked immunosorbent assay (ELISA) for interferon gamma (IFN-gamma), interleukin-2 (IL-2), IL-4, IL-10.

RESULTS: (1) The levels of IL-2 and IFN-gamma in AIT group [(108 +/- 37) ng/L and (110 +/- 52) ng/L, respectively] were lower significantly than those in NAIT group [(223 +/- 85) ng/L and (326 +/- 92) ng/L, respectively] (P < 0.05). The levels of IL-4 and IL-10 in AIT group [(50 +/- 11) ng/L and (140 +/- 37) ng/L, respectively] were higher than those in NAIT group [(23 +/- 11) ng/L and (52 +/- 28) ng/L] +/- (P < 0.05). The levels of IL-2 and IFN-gamma in NAIT group were higher than those in NNP group [(92 +/- 32) ng/L and (102 +/- 35) ng/L] (P < 0.05). The levels of IL-4 and IL-10 in NAIT group were lower than those in NNP group [(62 +/- 21) ng/L and (150 +/- 42) ng/L] (P < 0.05). The level of every cytokine had no difference in AIT group and NNP group (P > 0.05). (2) Twenty-six women in AIT group got pregnant, but 8 women experienced pregnancy loss repeatedly whose IL-2, IFN-gamma levels were higher than those in other 18 women got successful pregnancy and IL-4, IL-10 levels lower than the latter.

CONCLUSIONS: UHA patients have Th1 type immunity to trophoblast and produce high-level Th1 type cytokines which probably result in pregnancy loss. Active immunotherapy could make a shift from Th1 to Th2 immunity, thus favoring the maintenance of pregnancy.