Реферат: Aim of the study For successful embryo implantation and subsequent fetal development, an optimal balance of inflammatory and anti-inflammatory immune responses is necessary. Paternal lymphocyte immunization or LIT - immunization of women with allogeneic lymphocytes before pregnancy and in early pregnancy - is an effective way to correct immunoregulation in patients with recurrent miscarriage. The purpose of this study is to evaluate the effectiveness of lymphocyte immunotherapy in women with a history of idiopathic infertility and/or recurrent miscarriage. Methods It was a prospective cohort study which included patients with unexplained infertility or early reproductive losses in anamnesis. All women received LIT as monotherapy before a planned pregnancy. To study the immune status, the peripheral blood of patients was examined to determine the number of NK cells (CD3–CD(16+56+)), NKT cells (CD3+CD(16+56+)), CD107a spontaneously and after activation using the flow method cytofluorimetry. The study involved 80 married couples diagnosed with “recurrent miscarriage”, “unspecified female infertility” of idiopathic origin, as well as multiple implantation failures during ART (2 or more). Inclusion criteria were: woman's age from 20 to 40 years, two or more implantation failures during ART and/or two or more spontaneous abortions before 20 weeks from the same partner, if in each case a normal karyotype of the abortion was proven, a normal karyotype partners, typing of HLA class II genes at 3 loci (DQA1, DQB1, DRB1) of the couple, spontaneous onset of previous pregnancies, absence of anatomical, autoimmune, hormonal disorders, inflammatory diseases of the pelvic organs in the acute phase, an informed consent form signed by the patient for the study. LIT was carried out with the spouse's lymphocytes in preconceptional preparation in the middle of the follicular phase of two consecutive menstrual cycles and during the ensuing pregnancy at 5–6 weeks and/or 8–9 weeks. Results Thus, among this cohort of patients, pregnancy occurred in 87% of cases, where in 74,2% it ended in the birth of a healthy full-term newborn. Among patients with primary infertility and repeated implantation failures during IVF, pregnancy occurred in 35.3% of cases, while in 66,7% of this cohort the pregnancy ended in the birth of a full-term healthy child; two woman was diagnosed with a non-developing pregnancy. 85% of couples had a match for 2 or more loci in the HLA class II system, the most common variants of allelic matches for 2 loci are DQA1*0501/DRB1*11/ and DQA1*0501/DQB1*301/ (9.1% and 16.9%, respectively), for 3 loci DQA1*0201/DQB1*201/DRB1*07/ and DQA1*101-102/DQB1*501/DRB1*01/ (6.5% and 6.5%, respectively). Thus, attention is drawn to a group of 4 alleles, a coincidence among which was found in every second married couple: DQA1*101-102 and DQA1*0501 in 50% of cases, DQA1*0301 and DRB1*11 in 56.3% of cases. After comparing indicators of the functional activity of NK cells in the peripheral blood before LIT and 2 weeks after the 2nd procedure at the pregravid stage, there is a clear tendency towards regulation of the immune system: the total number of NK cells decreased on average by 5.14%. Conclusion. These results suggest that LIT is an effective therapy among patients with recurrent fetal loss and in 87% of cases leads to pregnancy and in 74% of cases to its prolongation after 13 weeks. The effect of the procedure is justified by its immunoregulatory functions, which is manifested by a decrease in the total number of NK cells, NKT cells and spontaneously activated CD107a.

Библиографическая ссылка: Shengelia M. , Khalenko V. , Bespalova O.
EFFECTS OF PATERNAL LYMPHOCYTE IMMUNIZATION IN COUPLES WITH HLA COMPATIBILITY AND EARLY REPRODUCTIVE LOSSES
HLA-G conference 07-08 Jul 2025