山东大学学报 (医学版) ›› 2021, Vol. 59 ›› Issue (8): 32-37.doi: 10.6040/j.issn.1671-7554.0.2021.0877
邓晓惠1,2,郭玲1,2
DENG Xiaohui1,2, GUO Ling1,2
摘要： 胚胎反复种植失败(RIF)是现代生殖医学领域研究的热点和难点问题,其发病因素繁多且复杂。随着生殖免疫学的不断兴起,近年来研究发现,免疫因素在胚胎种植过程中发挥重要作用,有针对性的免疫治疗方法可改善部分患者的妊娠结局。本文主要从RIF免疫因素的发病机制及相关免疫治疗方法的应用进展等方面进行综述,以期为未来的基础研究和临床治疗提供参考。
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| [1] Mak JSM, Chung CHS, Chung JPW, et al. The effect of endometrial scratch on natural-cycle cryopreserved embryo transfer outcomes: a randomized controlled study [J]. Reprod Biomed Online, 2017, 35(1): 28-36. [2] Thornhill AR, deDie-Smulders CE, Geraedts JP, et al. ESHRE PGD Consortium 'Best practice guidelines for clinical preimplantation genetic diagnosis(PGD)and preimplantation genetic screening(PGS)' [J]. Hum Reprod, 2005, 20(1): 35-48. [3] Coughlan C, Ledger W, Wang Q, et al. Recurrent implantation failure: definition and management [J]. Reprod Biomed Online, 2014, 28(1): 14-38. [4] Cakiroglu Y, Tiras B. Determining diagnostic criteria and cause of recurrent implantation failure [J]. Curr Opin Obstet Gynecol, 2020, 32(3): 198-204. [5] Bashiri A, Halper KI, Orvieto R. Recurrent Implantation Failure-update overview on etiology, diagnosis, treatment and future directions [J]. Reprod Biol Endocrinol, 2018, 16(1): 121. [6] 刘茜桐, 卢娜, 李佩, 等. 胚胎反复种植失败的免疫学预测指标[J]. 中华生殖与避孕杂志, 2018, 38(6): 517-520. [7] Lu HQ, Hu R. The role of immunity in the pathogenesis and development of pre-eclampsia [J]. Scand J Immunol, 2019, 90(5): e12756. [8] Liang PY, Diao LH, Huang CY, et al. The pro-inflammatory and anti-inflammatory cytokine profile in peripheral blood of women with recurrent implantation failure [J]. Reprod Biomed Online, 2015, 31(6): 823-826. [9] Kofod L, Lindhard A, Bzorek M, et al. Endometrial immune markers are potential predictors of normal fertility and pregnancy after in vitro fertilization [J]. Am J Reprod Immunol, 2017, 78(3):e12684. [10] 汪希鹏. 复发性流产与反复种植失败的病因和治疗新观点[J]. 中华妇产科杂志, 2019, 54(12): 793-796. WANG Xipeng. New opinions in etiology and therapy of recurrent spontaneous abortion and recurrent implantation failure[J]. Chinese Journal of Obstetrics and Gynecology, 2019, 54(12): 793-796. [11] Ledee-Bataille N, Bonnet-Chea K, Hosny G, et al. Role of the endometrial tripod interleukin-18, -15, and -12 in inadequate uterine receptivity in patients with a history of repeated in vitro fertilization-embryo transfer failure [J]. Fertil Steril, 2005, 83(3): 598-605. [12] Zhang T, Huang C, Du Y, et al. Successful treatment with intrauterine delivery of dexamethasone for repeated implantation failure[J]. Am J Reprod Immunol, 2017, 78(6):e12766. doi: 10.1111/aji.12766. [13] Ledee N, Prat-Ellenberg L, Petitbarat M, et al. Impact of prednisone in patients with repeated embryo implantation failures: beneficial or deleterious? [J]. J Reprod Immunol, 2018, 127(1): 11-15. [14] de Moreuil C, Alavi Z, Pasquier E. Hydroxychloroquine may be beneficial in preeclampsia and recurrent miscarriage [J]. Br J Clin Pharmacol, 2020, 86(1): 39-49. [15] Mekinian A, Lazzaroni MG, Kuzenko A, et al. The efficacy of hydroxychloroquine for obstetrical outcome in anti-phospholipid syndrome: data from a European multicenter retrospective study [J]. Autoimmun Rev, 2015, 14(6): 498-502. [16] Belizna C, Pregnolato F, Abad S, et al. HIBISCUS: hydroxychloroquine for the secondary prevention of thrombotic and obstetrical events in primary antiphospholipid syndrome [J]. Autoimmun Rev, 2018, 17(12): 1153-1168. [17] Schreiber K, Breen K, Cohen H, et al. HYdroxychloroquine to improve pregnancy outcome in women with anTIphospholipid antibodies(HYPATIA)protocol: a multinational randomized controlled trial of hydroxychloroquine versus placebo in addition to standard treatment in pregnant women with antiphospholipid syndrome or antibodies [J]. Semin Thromb Hemost, 2017, 43(6): 562-571. [18] Mekinian A, Vicaut E, Cohen J, et al. Hydroxychloroquine to obtain pregnancy without adverse obstetrical events in primary antiphospholipid syndrome: French phase II multicenter randomized trial, HYDROSAPL [J]. Gynecol Obstet Fertil Senol, 2018, 46(7-8): 598-604. [19] Mekinian A, Cohen J, Alijotas-Reig J, et al. Unexplained recurrent miscarriage and recurrent implantation failure: is there a place for immunomodulation? [J]. Am J Reprod Immunol, 2016, 76(1): 8-28. [20] Ghasemnejad-Berenji H, Ghaffari Novin M, Hajshafiha M, et al. Immunomodulatory effects of hydroxychloroquine on Th1/Th2 balance in women with repeated implantation failure [J]. Biomed Pharmacother, 2018, 107(1): 1277-1285. [21] Forsse A, Nielsen TH, Nygaard KH, et al. Cyclosporin A ameliorates cerebral oxidative metabolism and infarct size in the endothelin-1 rat model of transient cerebral ischaemia [J]. Sci Rep, 2019, 9(1): 3702. [22] Zhang T, Li Z, Liu T, et al. Cyclosporine a drug-delivery system for high-risk penetrating keratoplasty: Stabilizing the intraocular immune microenvironment [J]. PLoS One, 2018, 13(5): e0196571. [23] Du MR, Dong L, Zhou WH, et al. Cyclosporin a improves pregnancy outcome by promoting functions of trophoblasts and inducing maternal tolerance to the allogeneic fetus in abortion-prone matings in the mouse [J]. Biol Reprod, 2007, 76(5): 906-914. [24] Ling Y, Huang Y, Chen C, et al. Low dose Cyclosporin A treatment increases live birth rate of unexplained recurrent abortion — initial cohort study [J]. Clin Exp Obstet Gynecol, 2017, 44(2): 230-235. [25] Zhou WH, Du MR, Dong L, et al. Cyclosporin A increases expression of matrix metalloproteinase 9 and 2 and invasiveness in vitro of the first-trimester human trophoblast cells via the mitogen-activated protein kinase pathway [J]. Hum Reprod, 2007, 22(10): 2743-2750. [26] Nakagawa K, Kwak-Kim J, Ota K, et al. Immunosuppression with tacrolimus improved reproductive outcome of women with repeated implantation failure and elevated peripheral blood TH1/TH2 cell ratios [J]. Am J Reprod Immunol, 2015, 73(4): 353-361. [27] Azizi R, Ahmadi M, Danaii S, et al. Cyclosporine A improves pregnancy outcomes in women with recurrent pregnancy loss and elevated Th1/Th2 ratio [J]. J Cell Physiol, 2019, 234(4): 19039-19047. [28] Nakagawa K, Kwak-Kim J, Kuroda K, et al. Immunosuppressive treatment using tacrolimus promotes pregnancy outcome in infertile women with repeated implantation failures [J]. Am J Reprod Immunol, 2017, 78(3): e12682. [29] Perales-Puchalt A, Vila Vives JM, Lopez Montes J, et al. Pregnancy outcomes after kidney transplantation-immunosuppressive therapy comparison [J]. J Matern Fetal Neonatal Med, 2012, 25(8): 1363-1366. [30] Akturk S, Celebi ZK, Erdogmus S, et al. Pregnancy after kidney transplantation: outcomes, tacrolimus doses, and trough levels [J]. Transplant Proc, 2015, 47(5): 1442-1444. [31] Ahmadi M, Aghdam SA, Nouri M, et al. Intravenous immunoglobulin(IVIG)treatment modulates peripheral blood Th17 and regulatory T cells in recurrent miscarriage patients: non randomized, open-label clinical trial [J]. Immunol Lett, 2017, 192(1): 12-19. [32] Nyborg KM, Kolte AM, Larsen EC, et al. Immunomodulatory treatment with intravenous immunoglobulin and prednisone in patients with recurrent miscarriage and implantation failure after in vitro fertilization/intracytoplasmic sperm injection [J]. Fertil Steril, 2014, 102(6): 1650-1655. [33] Ramos-Medina R, Garcia-Segovia A, Gil J, et al. Experience in IVIg therapy for selected women with recurrent reproductive failure and NK cell expansion [J].Am J Reprod Immunol, 2014, 71(5): 458-466. [34] Ahmadi M, Abdolmohammadi-Vahid S, Ghaebi M, et al. Regulatory T cells improve pregnancy rate in RIF patients after additional IVIG treatment [J]. Syst Biol Reprod Med, 2017, 63(6): 350-359. [35] Han AR, Lee SK. Immune modulation of i.v. immunoglobulin in women with reproductive failure [J]. Reprod Med Biol, 2018, 17(2): 115-124. [36] Check JH, Liss JR, Check ML, et al. Lymphocyte immunotherapy can improve pregnancy outcome following embryo transfer(ET)in patients failing to conceive after two previous ET [J]. Clin Exp Obstet Gynecol, 2005, 32(1): 21-22. [37] Kamath MS, Chittawar PB, Kirubakaran R, et al. Use of granulocyte-colony stimulating factor in assisted reproductive technology: a systematic review and meta-analysis [J]. Eur J Obstet Gynecol Reprod Biol, 2017, 214(1): 16-24. [38] Arefi S, Fazeli E, Esfahani M, et al. Granulocyte-colony stimulating factor may improve pregnancy outcome in patients with history of unexplained recurrent implantation failure: an RCT [J]. Int J Reprod Biomed, 2018, 16(5): 299-304. [39] Kalem Z, Namli Kalem M, Bakirarar B, et al. Intrauterine G-CSF administration in recurrent implantation failure(RIF)[J]. An Rct Sci Rep, 2020, 10(1): 5139. [40] Liu X, Ma D, Wang W, et al. Intrauterine administration of human chorionic gonadotropin improves the live birth rates of patients with repeated implantation failure in frozen-thawed blastocyst transfer cycles by increasing the percentage of peripheral regulatory T cells [J]. Arch Gynecol Obstet, 2019, 299(4): 1165-1172. [41] Xie H, Zeng H, He D, et al. Effect of intrauterine perfusion of human chorionic gonadotropin before embryo transfer after two or more implantation failures: a systematic review and meta-analysis [J]. Eur J Obstet Gynecol Reprod Biol, 2019, 243(1): 133-138. [42] Volovsky M, Healey M, MacLachlan V, et al. Should intrauterine human chorionic gonadotropin infusions ever be used prior to embryo transfer? [J]. J Assist Reprod Genet, 2018, 35(2): 273-278. [43] Yu N, Zhang B, Xu M, et al. Intrauterine administration of autologous peripheral blood mononuclear cells(PBMCs)activated by HCG improves the implantation and pregnancy rates in patients with repeated implantation failure: a prospective randomized study [J]. Am J Reprod Immunol, 2016, 76(3): 212-216. [44] Heinz H P, Loos M. Activation of the first component of complement, C1: comparison of the effect of sixteen different enzymes on serum C1 [J]. Immunobiology, 1983, 165(2): 175-185. [45] Winger EE, Reed JL, Ashoush S, et al. Degree of TNF-alpha/IL-10 cytokine elevation correlates with IVF success rates in women undergoing treatment with Adalimumab(Humira)and IVIG [J]. Am J Reprod Immunol, 2011, 65(6): 610-618. |
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