Effects of intralipid infusions on anti-trophoblast antibody (ATAb)-activities in patients with recurrent pregnancy loss: An observational report

Rogenhofer, Nina; Mahner, Sven; von Hasselbach, Yumiko Lindgard und Thaler, Christian J. (2021): Effects of intralipid infusions on anti-trophoblast antibody (ATAb)-activities in patients with recurrent pregnancy loss: An observational report. In: American Journal of Reproductive Immunology, Bd. 87, Nr. 2, e13506

Abstract

Problem Some studies suggest intravenous intralipid infusions (IVIL) to be effective in the treatment of immune-mediated pregnancy failure. To this date it remains to be established, how IVIL might protect pregnancy and therefore a specific subgroup of RPL patients that might benefit from IVIL has not been defined. Anti-trophoblast antibodies (ATAb) have been associated with RPL and appear to mediate immune pathology. We have shown, that ATAb in vitro decrease HCG- and progesterone production pointing to a mechanism how ATAb interfere with normal pregnancies. We have measured ATAb-activities in patients undergoing off label IVIL-treatment. Method of study Ten RPL-patients with positive ATAb, determined by using the choriocarcinoma cellline JEG-3 and flow cytometry as described before, and otherwise unexplained RPL, received off-label IVIL during pregnancy. Two ATAb-positive RPL patients preferred expectant management. In addition, ATAb-activity was studied in pregnancies of two healthy ATAb-negative volunteers without miscarriages. Results In RPL patients receiving IVIL, relative ATAb-activity decreased from an average of 56.8 +/- 17.0% to 20.8 +/- 11.0% (P < .001). The two RPL-patients without IVIL, aborted at 6+3gw and 7+4gw and embryonic genetic testing revealed euploid karyotypes. During pregnancies of the two healthy ATAb-negative individuals, ATAb-activities remained negative (16 +/- 9.8%) without significant changes (P = .22). Nine of the 10 pregnancies receiving IVIL proceeded uneventful with healthy newborns >= 37gw. One patient receiving IVIL aborted at 7+6gw and embryonic genetic-testing revealed a trisomy 16. No specific side effects concerning IVIL were noted. Conclusions Intralipid preparations during pregnancies of ATAb-positive RPL-patients significantly reduce ATAb-activities and this may indicate a therapeutic mechanism of IVIL.

• Dokumententyp: Zeitschriftenartikel
• Fakultät: Medizin
• Themengebiete: 600 Technik, Medizin, angewandte Wissenschaften > 610 Medizin und Gesundheit
• ISSN: 1046-7408
• Sprache: Englisch