Journal of Nippon Medical School: Vol.71 No.5 page.308

Journal of Nippon Medical School

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ArticleTitle Diagnosis and Treatment of Recurrent Miscarriage Associated with Immunologic Disorders: Is Paternal Lymphocyte Immunization a Relic of the Past?

AuthorList Toshiyuki Takeshita

Affiliation Department of Obstetrics and Gynecology, Nippon Medical School

Language EN

Volume 71

Issue 5

Year 2004

Page 308-313

Received June 1, 2004

Accepted July 1, 2004

Keywords recurrent miscarriage, alloimmune, paternal lymphocyte immunization

Abstract Miscarriage is the most common complication of human pregnancy. Although the causes of recurrent miscarriage (RM) are various, immunologic aberrations between mother and fetus might be one of the causes of miscarriage. Immune responses fall into two categories: autoimmune and alloimmune. Currently, no appropriate diagnostic method has been established to identify alloimmune causes. We observed that NK cell activity in women with RM was higher than that in women without a history of miscarriage. Functional or quantitative analysis of NK cells could be used to identify alloimmune causes. Paternal lymphocyte immunization has been the most widely used treatment for alloimmune-mediated miscarriages. However, the latest Cochrane review by Scott reached the current conclusion that lymphocyte immunization therapy provided no significant beneficial effect over placebo in preventing further miscarriage. Approximately 70% of Japanese university hospitals are still performing paternal lymphocyte immunization. Is paternal lymphocyte immunization a relic of the past? Randomized controlled trials based on adequate patient selection in Japan should provide an answer to this question.

Correspondence to Toshiyuki Takeshita, Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan
toshimac@nms.ac.jp

ArticleTitle	Diagnosis and Treatment of Recurrent Miscarriage Associated with Immunologic Disorders: Is Paternal Lymphocyte Immunization a Relic of the Past?
AuthorList	Toshiyuki Takeshita
Affiliation	Department of Obstetrics and Gynecology, Nippon Medical School
Language	EN
Volume	71
Issue	5
Year	2004
Page	308-313
Received	June 1, 2004
Accepted	July 1, 2004
Keywords	recurrent miscarriage, alloimmune, paternal lymphocyte immunization
Abstract	Miscarriage is the most common complication of human pregnancy. Although the causes of recurrent miscarriage (RM) are various, immunologic aberrations between mother and fetus might be one of the causes of miscarriage. Immune responses fall into two categories: autoimmune and alloimmune. Currently, no appropriate diagnostic method has been established to identify alloimmune causes. We observed that NK cell activity in women with RM was higher than that in women without a history of miscarriage. Functional or quantitative analysis of NK cells could be used to identify alloimmune causes. Paternal lymphocyte immunization has been the most widely used treatment for alloimmune-mediated miscarriages. However, the latest Cochrane review by Scott reached the current conclusion that lymphocyte immunization therapy provided no significant beneficial effect over placebo in preventing further miscarriage. Approximately 70% of Japanese university hospitals are still performing paternal lymphocyte immunization. Is paternal lymphocyte immunization a relic of the past? Randomized controlled trials based on adequate patient selection in Japan should provide an answer to this question.
Correspondence to	Toshiyuki Takeshita, Department of Obstetrics and Gynecology, Nippon Medical School, 1-1-5 Sendagi, Bunkyo-ku, Tokyo 113-8603, Japan toshimac@nms.ac.jp