Evaluation of failed immunotherapy among patients with negative APLA recurrent spontaneous abortion by serum anticardiolipin antibodies and mononuclear cell of Tim-1.

OBJECTIVE The present study is aimed to analyze the expression of serum anticardiolipin antibody (ACA) and mononuclear cells of Tim-1 among the patients with negative anti paternal lymphocyte antibody (APLA) recurrent spontaneous abortion conducted by lymphocyte immunotherapy resulting in failure. PATIENTS AND METHODS 58 patients with negative APLA recurrent spontaneous abortion (RSA) who was diagnosed for the first time and received lymphocyte immunotherapy in our hospital were selected continuously. According to the therapeutic outcome, the patients were divided into success group with 31 cases and failure group with 27 cases. The positive rate of APLA and ACA in serum were compared, as well as the expressions of serum IL-6, IL-10, TNF-α, and IFN-γ were studied by the method of ELISA. Furthermore, the ratios of CD4+CD25+ regulatory T cells (Treg) were detected by flow cytometry, and mRNA expression levels of Tim-1 were tested by the fluorogenic quantitative RT-PCR method. RESULTS The positive rate of APLA after treatments of both the groups were compared, without any difference. The positive rate of ACA in failure group before treatment was higher than the data of after treatment, and the difference was statistically significant (p < 0.05). After treatment, serum IL-6 and IL-10 levels of two groups increased, TNF-α and IFN-γ levels were observed to be decreased in comparison with the data before treatment. Furthermore, the improvement in success group was greater than failure group, and the difference was statistical significant (p < 0.05). After treatment, Treg proportion of two groups increased compared with before, and the proportion of success group was greater than that of failure group; mRNA expression levels of Tim-1 in failure group before and after treatment were higher than that of success group, and the differences had statistical significance (p < 0.05). CONCLUSIONS High level of serum anticardiolipin antibody and mononuclear cell Tim-1 might lead to failed immunotherapy for the patients with negative APLA recurrent spontaneous abortion by influencing T lymphocyte immunity.